OUTCOME VALIDATION OF A SUCCINCT HPV INFECTION MODEL FOR FRANCE

Author(s)

Nadia Demarteau, BioIr, MEPC, Health Economist1, B Detournay, MD, Consultant2, A. El Hasnaoui, MD, Director3, B. Standaert, MD, Director4, Lieven Annemans, PhD, Senior Consultant51IMS HEOR, Brussels, Belgium; 2 CEMKA-EVAL, Bourg-la-Reine, France; 3 GlaxoSmithKline France, Marly-Le-Roi Cedex, France; 4 GlaxoSmithKline Biologicals, Rixensart, Belgium; 5 Health Economics and Outcomes Research, Brussels, Belgium

OBJECTIVES: An HPV/cancer epidemiology model has been developed aiming to be succinct in structure and data input providing valid long-term HPV infection and cancer case predictions, a first step for estimating cost-effectiveness of new HPV vaccines. METHODS: A lifetime Markov process model with one year cycle length has been selected as basic matrix and is developed in Microsoft®Excel software. The model structure describes the natural history of High-Risk HPV (HR-HPV) infections through 9 health states: No-HPV; HR-HPV without lesions; low and high grade Cervical Intraepithelial Neoplasia (CIN1 and CIN23); persistent CIN23; CC; cured CC; CC death; and overall death. A screening module (organized and/or opportunistic) simulates early detection and treatment of CIN lesions reducing their progression to CC. Two types of data-sets for data-input are created: related to the natural history of the disease (supposed to be equivalent across countries and extracted from literature or from expert opinion) and country-specific (HPV incidence, death rate, screening practice, CIN and cancer specific treatment). Outcome model validation is performed with French data comparing model predicted cervical cancer incidence and mortality rates with estimates from national cancer registries. RESULTS: The model predicts 1.7 cases per 100,000 subjects in 20 to 24 age-group (1.3 observed); 21.3 cases in 40 to 44 age-group (19.8 observed); 17.9 cases in 75 to 79 age-group (17.2 observed). Overall the model overestimates the CC cases with only 5% (n = 3569 modeled cancer cases; 3387 observed for the year 2000). CONCLUSION: Succinct model development is able to replicate within 5% confidence the CC incidence observed. The model is a helpful tool for simulating economical consequences of HPV vaccine in those countries with paucity of data which doesn't allow using the more complex models.

Conference/Value in Health Info

2006-10, ISPOR Europe 2006, Copenhagen, Denmark

Value in Health, Vol. 9, No.6 (November/December 2006)

Code

PCN56

Topic

Clinical Outcomes

Topic Subcategory

Clinical Outcomes Assessment

Disease

Oncology

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