OBJECTIVES: Sophisticated models are required to predict the epidemiologic and economic benefits of vaccination against human papillomavirus (HPV) at the population level. This study compared PRIME, a modeling tool available from the WHO, with a newly developed prediction tool, the HPV Insights model. PRIME uses a static model to assess a single female birth cohort, whereas HPV Insights uses a dynamic transmission model to assess the direct and indirect (herd immunity) population-wide effects of HPV vaccination. In this analysis, HPV Insights was constrained to female-only vaccination and cervical cancer (CC)-related outcomes for the purposes of comparison.

METHODS: Using a 53% HPV vaccine coverage rate, 75% efficacy of the vaccine against HPV types 16 and 18 (assuming 72.4% of CC is attributable to these types), a vaccination course cost of €236, a CC treatment cost of €20,762, and 2% cost discounting, we estimated the total net costs of vaccination and CC treatment and the number of CC deaths averted using both PRIME and HPV Insights. PRIME followed a female birth cohort from the Netherlands (N=86,069) for the duration of their lives, while HPV Insights followed the entire Dutch population for 100 years. The primary outcome of interest was cost per life saved.

RESULTS: The PRIME tool estimated a total net cost of €14,700,062 for the female birth cohort, with 330 CC deaths averted and a total cost per life saved of €44,546. HPV Insights estimated a total net cost of €919,738,800 for the entire female population, with 44,801 CC deaths averted and a total cost per life saved of €20,529.

CONCLUSIONS: A dynamic transmission model provides a more complete picture of the health and economic effects of HPV vaccination than a static model, demonstrating a much smaller cost per life saved when an entire population is considered.