OBJECTIVES: To estimate the opportunity cost that are achievable with an increased coverage rate of anti-HPV9 vaccination in Italy.

METHODS: A cost consequence model was developed in order to estimate the HPV-related diseases incurred from a hypothetical Italian cohort of women and boys. The model considers the age risks of hospitalization for: genital warts (GW); ‘cervical intraepithelial neoplasia (CIN)’ (067.32-067.33); ‘condyloma acuminatum’ (078.11); ‘anal cancers’ (AC) (154.2–154.8); oropharyngeal cancers (OC): ‘oropharyngeal cancer’(146.0–146.9) and ‘head, face and neck cancers’ (171.0); genital cancers (GC): ‘penis cancer’ (187.1–187.9) and ‘cervical cancer’ (180.0–180.9). Other direct healthcare costs were estimated from the literature while indirect costs (social security benefits) were associated with incident patients considering the data coming from the Italian National Institute of Social Security (INPS). Vaccine Efficacy data were taken from HPV9 vaccine RCP and literature.Different scenarios were compared based on the vaccination coverage rates (VCRs): No vaccination (0% of VCR for both male and female), ‘as is scenario’ (70% of VCR for female and 45% coverage for Male as observed for the l.a.y. 2017) and Optimal Vaccination Strategy (95% of VCR for both male and female). All scenarios have a lifetime projection.

RESULTS: The model estimates a total economic burden of the Hpv related diseases of about € 160 million (60% attributable to indirect costs) in the absence of HPV9 vaccination. The ’as is’ VCRs are likely to reduce € 23.9 million of direct healthcare costs and € 34.9 million of indirect costs. An Optimal Vaccination Strategy could reduce over € 85.9 million of direct and indirect cost if compared to the no Vaccination strategy and € 27.0 Mln if compared to the Standard Vaccination Strategy (€ 112 Mln, over 70% of the estimated total Hpv economic burden).

CONCLUSIONS: These results suggest that increasing Vaccination coverage rates could generate important advantages in terms of opportunity costs.