Evaluating the Health Impact and Cost-Effectiveness of Gender-Neutral Vaccination of 9-Valent Human Papillomavirus Vaccine in the Philippines Using a Dynamic Transmission Model
Author(s)
GEOVIN DEXTER C. UY, RPh, MPH1, Karlo Paredes, MPH1, Mary Ann Galang Escalona, MD1, Andrew Pavelyev, PhD2, Isaya Sukarom, PhD3, Alhaji Cherif, DPhil2.
1MSD Philippines, Makati City, Philippines, 2Merck & Co., Inc, Rahway, NJ, USA, 3MSD Thailand, Bangkok, Thailand.
1MSD Philippines, Makati City, Philippines, 2Merck & Co., Inc, Rahway, NJ, USA, 3MSD Thailand, Bangkok, Thailand.
OBJECTIVES: The Philippines, which anchors to WHO Cervical Cancer Elimination Agenda, intends to explore expansion of national immunization program (NIP) to include males thru review of health technology assessment. Previous local study found that 9-valent human papillomavirus (9vHPV) vaccine for female-only vaccination (FOV) was cost-effective as compared to the current FOV with 4-valent HPV vaccine (4vHPV) used in NIP. This study aims to assess the public health impact and cost-effectiveness of 9vHPV vaccination for males and females (gender neutral vaccination, GNV) compared with 4vHPV GNV.
METHODS: A previously validated dynamic transmission model was used to compare outcomes of using 9vHPV GNV strategy with 4vHPV GNV strategy for those aged 9-14 years assuming 2-dose schedule and 90% coverage for both males and females. The study, utilizing local data, evaluated HPV-associated health outcomes including cervical lesions (CIN 1/2/3), cervical, head and neck (H&N), vaginal, vulvar, penile, and anal cancers, and genital warts. Costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER) were calculated, considering lifelong vaccine protection, herd immunity, and 3.66% discount rate on both costs and outcomes.
RESULTS: 9vHPV GNV strategy would reduce significant number of cervical lesions and cancer cases (103,566 cervical cancer, 1,440,588 CIN-1/2/3, HPV-related cancers: 1036 H&N; 190 vaginal; 266 vulval; 335 penile), and deaths (46,526 cervical cancer, HPV-related cancers: 571 H&N; 89 vaginal; 93 vulval; 105 penile) versus 4vHPV GNV strategy. Moreover, 9vHPV GNV strategy reduced disease management costs by 5.4% versus 4vHPV GNV strategy. Compared to 4vHPV GNV strategy, 9vHPV GNV strategy was considered cost-saving. Results from sensitivity analyses on varying vaccination coverage showed that 9vHPV GNV strategy remained cost-saving.
CONCLUSIONS: Expansion to 9vHPV vaccination strategy in NIP and to include both males and females 9-14 years of age is projected to be cost saving through additional public health benefits with reductions in both HPV-related disease incidence and costs.
METHODS: A previously validated dynamic transmission model was used to compare outcomes of using 9vHPV GNV strategy with 4vHPV GNV strategy for those aged 9-14 years assuming 2-dose schedule and 90% coverage for both males and females. The study, utilizing local data, evaluated HPV-associated health outcomes including cervical lesions (CIN 1/2/3), cervical, head and neck (H&N), vaginal, vulvar, penile, and anal cancers, and genital warts. Costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER) were calculated, considering lifelong vaccine protection, herd immunity, and 3.66% discount rate on both costs and outcomes.
RESULTS: 9vHPV GNV strategy would reduce significant number of cervical lesions and cancer cases (103,566 cervical cancer, 1,440,588 CIN-1/2/3, HPV-related cancers: 1036 H&N; 190 vaginal; 266 vulval; 335 penile), and deaths (46,526 cervical cancer, HPV-related cancers: 571 H&N; 89 vaginal; 93 vulval; 105 penile) versus 4vHPV GNV strategy. Moreover, 9vHPV GNV strategy reduced disease management costs by 5.4% versus 4vHPV GNV strategy. Compared to 4vHPV GNV strategy, 9vHPV GNV strategy was considered cost-saving. Results from sensitivity analyses on varying vaccination coverage showed that 9vHPV GNV strategy remained cost-saving.
CONCLUSIONS: Expansion to 9vHPV vaccination strategy in NIP and to include both males and females 9-14 years of age is projected to be cost saving through additional public health benefits with reductions in both HPV-related disease incidence and costs.
Conference/Value in Health Info
2025-09, ISPOR Real-World Evidence Summit 2025, Tokyo, Japan
Value in Health Regional, Volume 49S (September 2025)
Code
RWD237
Topic Subcategory
Health & Insurance Records Systems
Disease
STA: Vaccines