OBJECTIVES:

The objective of this study is to estimate the economic burden associated with Human Papilloma Virus considering the new universal vaccination strategy in Italy (National Immunization Plan 2017-19), and total direct medical costs preventable associated with nine major HPV-related diseases.

METHODS:

A Cost of Illness incidence based model was developed in order to estimate incidence and costs of invasive cervical cancer, cervical dysplasia, cancer of the vulva, vagina, anus, penis, head and neck, anogenital warts, and recurrent respiratory papillomatosis from the Italian National Health System Perspective. For each of the nine conditions, we used available Italian secondary data to estimate the lifetime cost per case, the number of incident cases of each disease, the total economic burden, and the relative prevalence of HPV types 6, 11, 16, 18, 31, 33, 45, 52, 58 in order to estimate the aggregate fraction of the total economic burden attributable to HPV infection.

RESULTS:

The total direct costs (expressed in 2017 Euro) associated with the annual incident cases of the nine HPV-related conditions included in the analysis were estimated to be €503.2 million, with a plausible range of €492.7– 651.9 million. The fraction attributable to the HPV9 was €320.0 (range €298– €342 million), accounting for approximately 63.6% of the total annual burden of HPV-related disease in Italy.

CONCLUSIONS:

Comparing our data to the previous analysis conducted in 2011, the introduction of primary and secondary prevention strategy was an important step forward in public health because of the reduced incidence rates of HPV related diseases and consequently costs (from €503,2 to €534.5 million estimated in 2011). Moreover the new HPV9 vaccine represents an important investment for the public health that could prevent about 64% (range 60% - 68%) of total Economic Burden compared to 59% in the vaccination strategies available in 2011 preventable costs.