EPIDEMIOLOGIC AND ECONOMIC IMPACT OF HPV (6/11/16/18) VACCINATION IN TURKEY

Author(s)

Bakir M1, Levent A2, Nagy L3, Brandtmüller A3, Singhal P4, Pillsbury M4, Dasbach E51Marmara University Medical School, Istanbul, Turkey, 2Hacettepe University Medical School, Ankara, Sihhiye, Turkey, 3Merck Sharp and Dohme, Budapest, Hungary, 4Merck & Co.

OBJECTIVES: to assess the epidemiological and economic impact of a quadrivalent human papillomavirus (HPV) types 6/11/16/18 vaccination in Turkey. METHODS:  a published mathematical model of the transmission dynamics of HPV infection and disease was adapted for Turkey.  The model captured direct protective effects of vaccination and indirect effects (herd immunity).  Model inputs were used from Turkey when available; otherwise, the default values in the original model were used. The vaccination strategy included HPV vaccination of 12-year-old girls combined with current cervical cancer screening and HPV disease treatment practices in Turkey. For the vaccination strategy 85% coverage rate was assumed in the frame of a mandatory school-based program. Reference strategy was current cervical cancer screening and HPV disease treatment practices in Turkey. Costs were estimated from the perspective of the Turkish healthcare system, using direct medical costs associated with the diagnosis and treatment of cervical diseases. RESULTS: Over 100 years, cumulative % (absolute) reduction in the incidence of 6/11/16/18-related cases of CIN1, CIN2/3, cervical cancer, cervical cancer deaths, genital warts-female, and genital-warts-male was 78% (4,894), 72% (32,537), 57% (73,277), 54% (40,513), 86% (404,674), and 86% (409,029), respectively, in the vaccination group compared to the reference group.  Number of 6/11/16/18-related CIN1, CIN2/3, cervical cancer, cervical cancer deaths, and genital warts (both in female and male population) was halved in the vaccination strategy group compared to the reference strategy group by year 19, 24, 41, 44, and 14, respectively.  The incremental cost-effectiveness ratio for routine vaccination of 12-year-old girls was 18,251 TRY/QALY over 100 years. CONCLUSIONS: A quadrivalent HPV vaccination program can reduce the incidence of cervical cancer, CINs and genital warts in Turkey at a cost-per-QALY ratio within the range defined as cost effective.  

Conference/Value in Health Info

2011-11, ISPOR Europe 2011, Madrid, Spain

Value in Health, Vol. 14, No. 7 (November 2011)

Code

PCN75

Topic

Economic Evaluation

Topic Subcategory

Cost-comparison, Effectiveness, Utility, Benefit Analysis

Disease

Infectious Disease (non-vaccine), Oncology, Respiratory-Related Disorders, Vaccines

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