OBJECTIVES : The objective of these analyses is to assess the epidemiologic (cervical cancer [CC], cervical intraepithelial neoplasia [CIN], and genital warts [GW]) and economic impact of quadrivalent (6/11/16/18) HPV vaccination in 9-10 year-old females at higher vaccine coverage rates (VCRs) than currently observed in Colombia.

METHODS : A published dynamic HPV disease transmission model that accounts for herd protection effects with a 100-year time horizon was calibrated to estimate epidemiological impact and cost utility of increasing the VCR from 35% to 50% and 80%. The discount rate applied for costs and health outcomes was 3%. Colombian specific data were used for calibration.

RESULTS : Over 100 years, increasing VCR to 50% showed a reduction in disease incidence in females compared with the current program: CC (6.1%; 14,868 cases), HPV16/18-related CIN-1 (7.8%; 197,500 cases), CIN-2/3 (7.6%; 484,612 cases), HPV6/11-related CIN-1 (5.5%, 69,985 cases), and GW (6.4%; 1,351,382 cases), and in males: GW (3.4%; 814,236 cases). At a higher VCR (80%), the model showed a reduction in the disease incidence in females: CC (17.1%; 42,906 cases), HPV16/18-related CIN-1 (22.5%; 572,907 cases), CIN-2/3 (22.2%; 1,404,672 cases), HPV6/11-related CIN-1 (16.4%, 209,721 cases), and GW (19.0%; 3,983,576 cases), and in males: GW (10.4%; 2,474,263 cases). The disease management cost savings (cost of vaccination – disease costs avoided) at 50% VCR and 80% VCR were USD$65,403,069 and USD$188,463,623, respectively, over 100 years. The two strategies proved to be cost savings with strongly dominating ICERs.

CONCLUSIONS : In Colombia, increasing VCR of quadrivalent HPV vaccination would result in important incremental epidemiological and economic cost savings. These findings are conservative given that other HPV-related cancers in males and females and indirect costs were not considered; their inclusion would likely increase the estimated cost-savings.