COST-EFFECTIVENESS ANALYSIS OF HPV VACCINATION IN SLOVENIA

OBJECTIVES: The objective of the present study is to evaluate the cost-effectiveness of HPV vaccination alongside cervical cancer screening programme in Slovenia. METHODS: A Markov model representing natural history of HPV infection was adapted to Slovenian context. The model followed a cohort of 12 year-old girls until the age of 85 years. Two strategies were compared: HPV vaccination alongside conventional cytological screening versus screening alone. The analysis considered the benefits of HPV vaccination on the incidence of cervical cancer and precancerous cervical lesions. The analysis was performed from the health care payer perspective. RESULTS: Vaccination with screening compared to screening alone was associated with an incremental cost-effectiveness ratio (ICER) of €7568 per quality adjusted life-year (QALY) gained and €13,494 per life-year gained (LYG). Sensitivity analyses demonstrated that the ICER was robust to parameters but was most sensitive to the need for booster dose and to different values of discount rates. CONCLUSIONS: According to the cost-effectiveness thresholds used in the developed countries, HPV vaccine to current screening programme in Slovenia can be regarded as cost-effective.