Cost-effectiveness of human papillomavirus vaccination in Germany
Damm O, Horn J, Mikolajczyk RT, Kretzschmar MEE, Kaufmann AM, Deleré Y, Ultsch B, Wichmann O, Krämer A, Greiner W (2017)
Cost Effectiveness and Resource Allocation 15(1): 18.
Zeitschriftenaufsatz
| Veröffentlicht | Englisch
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s12962-017-0080-9.damm.pdf
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Autor*in
Damm, OliverUniBi;
Horn, Johannes;
Mikolajczyk, Rafael T.;
Kretzschmar, Mirjam E. E.;
Kaufmann, Andreas M.;
Deleré, Yvonne;
Ultsch, Bernhard;
Wichmann, Ole;
Krämer, AlexanderUniBi 
;
Greiner, WolfgangUniBi
;
Greiner, WolfgangUniBiEinrichtung
Abstract / Bemerkung
Background
The aim of this study was to assess the cost-effectiveness of human papillomavirus (HPV) vaccination in addition to the current cervical cancer screening programme in Germany using a dynamic transmission model.
Methods
Based on a mathematical model simulating the transmission dynamics and the natural history of HPV infection and associated diseases (cervical intraepithelial neoplasia, cervical cancer, and genital warts), we estimated the epidemiological and economic consequences of HPV vaccination with both the quadrivalent and bivalent vaccines. In our base case analysis, we assessed the cost-effectiveness of vaccinating 12-year-old girls with a 3-dose schedule. In sensitivity analysis, we also evaluated the use of a 2-dose schedule and assessed the impact of vaccinating boys.
Results
From a health care payer perspective, incremental cost-effectiveness ratios (ICERs) of a 3-dose schedule were €34,249 per quality-adjusted life year (QALY) for the bivalent and €14,711 per QALY for the quadrivalent vaccine. Inclusion of indirect costs decreased ICERs by up to 40%. When adopting a health care payer perspective, ICERs of a 2-dose approach decreased to €19,450 per QALY for the bivalent and to €3645 per QALY for the quadrivalent vaccine. From a societal perspective, a 2-dose approach using the quadrivalent vaccine was a cost-saving strategy while using the bivalent vaccine resulted in an ICER of €13,248 per QALY. Irrespective of the perspective adopted, additional vaccination of boys resulted in ICERs exceeding €50,000 per QALY, except for scenarios with low coverage (20%) in girls.
Conclusions
Our model results suggest that routine HPV vaccination of 12-year-old girls with three doses is likely to be cost-effective in Germany. Due to the additional impact on genital warts, the quadrivalent vaccine appeared to be more cost-effective than the bivalent vaccine. A 2-dose schedule of the quadrivalent vaccine might even lead to cost savings when adopting a societal perspective. The cost-effectiveness of additional vaccination of boys was highly dependent on the coverage in girls.
Stichworte
HPV Vaccination Economic evaluation Cost-effectiveness Dynamic transmission model Germany
Erscheinungsjahr
2017
Zeitschriftentitel
Cost Effectiveness and Resource Allocation
Band
15
Ausgabe
1
Art.-Nr.
18
ISSN
1478-7547
Page URI
https://pub.uni-bielefeld.de/record/2914076
Zitieren
Damm O, Horn J, Mikolajczyk RT, et al. Cost-effectiveness of human papillomavirus vaccination in Germany. Cost Effectiveness and Resource Allocation. 2017;15(1): 18.
Damm, O., Horn, J., Mikolajczyk, R. T., Kretzschmar, M. E. E., Kaufmann, A. M., Deleré, Y., Ultsch, B., et al. (2017). Cost-effectiveness of human papillomavirus vaccination in Germany. Cost Effectiveness and Resource Allocation, 15(1), 18. doi:10.1186/s12962-017-0080-9
Damm, Oliver, Horn, Johannes, Mikolajczyk, Rafael T., Kretzschmar, Mirjam E. E., Kaufmann, Andreas M., Deleré, Yvonne, Ultsch, Bernhard, Wichmann, Ole, Krämer, Alexander, and Greiner, Wolfgang. 2017. “Cost-effectiveness of human papillomavirus vaccination in Germany”. Cost Effectiveness and Resource Allocation 15 (1): 18.
Damm, O., Horn, J., Mikolajczyk, R. T., Kretzschmar, M. E. E., Kaufmann, A. M., Deleré, Y., Ultsch, B., Wichmann, O., Krämer, A., and Greiner, W. (2017). Cost-effectiveness of human papillomavirus vaccination in Germany. Cost Effectiveness and Resource Allocation 15:18.
Damm, O., et al., 2017. Cost-effectiveness of human papillomavirus vaccination in Germany. Cost Effectiveness and Resource Allocation, 15(1): 18.
O. Damm, et al., “Cost-effectiveness of human papillomavirus vaccination in Germany”, Cost Effectiveness and Resource Allocation, vol. 15, 2017, : 18.
Damm, O., Horn, J., Mikolajczyk, R.T., Kretzschmar, M.E.E., Kaufmann, A.M., Deleré, Y., Ultsch, B., Wichmann, O., Krämer, A., Greiner, W.: Cost-effectiveness of human papillomavirus vaccination in Germany. Cost Effectiveness and Resource Allocation. 15, : 18 (2017).
Damm, Oliver, Horn, Johannes, Mikolajczyk, Rafael T., Kretzschmar, Mirjam E. E., Kaufmann, Andreas M., Deleré, Yvonne, Ultsch, Bernhard, Wichmann, Ole, Krämer, Alexander, and Greiner, Wolfgang. “Cost-effectiveness of human papillomavirus vaccination in Germany”. Cost Effectiveness and Resource Allocation 15.1 (2017): 18.
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MD5 Prüfsumme
2050c886488ea0fe1d5881031aa4667a
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Kreimer AR, Struyf F, Del Rosario-Raymundo MR, Hildesheim A, Skinner SR, Wacholder S, Garland SM, Herrero R, David MP, Wheeler CM; Costa Rica Vaccine Trial Study Group Authors, Gonzalez P, Jimenez S, Lowy DR, Pinto LA, Porras C, Rodriguez AC, Safaeian M, Schiffman M, Schiller JT, Schussler J, Sherman ME; PATRICIA Study Group Authors, Bosch FX, Castellsague X, Chatterjee A, Chow SN, Descamps D, Diaz-Mitoma F, Dubin G, Germar MJ, Harper DM, Lewis DJ, Limson G, Naud P, Peters K, Poppe WA, Ramjattan B, Romanowski B, Salmeron J, Schwarz TF, Teixeira JC, Tjalma WA; HPV PATRICIA Principal Investigators/Co-Principal Investigator Collaborators; GSK Vaccines Clinical Study Support Group, Garland SM, Mindel A, Skinner SR, De Sutter P, Poppe WA, Tjalma WA, De Carvalho NS, Naud P, Teixeira JC, Aoki FY, Diaz-Mitoma F, Ferguson L, Miller M, Papp K, Ramjattan B, Romanowski B, Orr PH, Apter D, Karppa T, Kudjoi N, Lehtinen M, Lonnberg K, Palmroth J, Paavonen J, Petaja T, Tuomivaara L, Gent T, Grubert T, Hopker WD, Peters K, Schulze K, Schwarz TF, Waddell R, Salmeron J, Crisostomo C, Del Rosario-Raymundo MR, Raymundo JE, Germar MJ, Limson G, Villanueva G, Zamora JD, Bajo-Arenas J, Bayas J, Campins M, Castellsague X, Castro M, Centeno C, Rodriguez de la Pinta ML, Torne A, Vidart JA, Chow SN, Yu MH, Cruickshank M, Hakim EA, Lewis D, Szarewski A, Ackerman R, Caldwell M, Chambers C, Chatterjee A, DeMars L, Fine P, Huh W, Klein T, Lalezari J, Leeman L, Luber S, Martens M, Peterson C, Rosen J, Seidman L, Sperling R, Stager M, Stapleton J, Waldbaum A, Wheeler CM, Colau B, Genevrois S, Martens N, Houard N, Poncelet S, Provenzano C, Tonglet A, Van Hoof C, Descamps D, Hardt K, Xhenseval V, Zahaf T, Alt E, Iskaros B, Limaye A, Luff RD, McNeeley M, Winkler B, Molijn A, Quint W, Struijk L, Van de Sandt M, Van Doorn LJ, Klugman KP, Nieminen P, Bergeron C, Eisenstein E, Karron R, Marks R, Nolan T, Tay SK., Lancet Oncol. 16(7), 2015
PMID: 26071347
Kreimer AR, Struyf F, Del Rosario-Raymundo MR, Hildesheim A, Skinner SR, Wacholder S, Garland SM, Herrero R, David MP, Wheeler CM; Costa Rica Vaccine Trial Study Group Authors, Gonzalez P, Jimenez S, Lowy DR, Pinto LA, Porras C, Rodriguez AC, Safaeian M, Schiffman M, Schiller JT, Schussler J, Sherman ME; PATRICIA Study Group Authors, Bosch FX, Castellsague X, Chatterjee A, Chow SN, Descamps D, Diaz-Mitoma F, Dubin G, Germar MJ, Harper DM, Lewis DJ, Limson G, Naud P, Peters K, Poppe WA, Ramjattan B, Romanowski B, Salmeron J, Schwarz TF, Teixeira JC, Tjalma WA; HPV PATRICIA Principal Investigators/Co-Principal Investigator Collaborators; GSK Vaccines Clinical Study Support Group, Garland SM, Mindel A, Skinner SR, De Sutter P, Poppe WA, Tjalma WA, De Carvalho NS, Naud P, Teixeira JC, Aoki FY, Diaz-Mitoma F, Ferguson L, Miller M, Papp K, Ramjattan B, Romanowski B, Orr PH, Apter D, Karppa T, Kudjoi N, Lehtinen M, Lonnberg K, Palmroth J, Paavonen J, Petaja T, Tuomivaara L, Gent T, Grubert T, Hopker WD, Peters K, Schulze K, Schwarz TF, Waddell R, Salmeron J, Crisostomo C, Del Rosario-Raymundo MR, Raymundo JE, Germar MJ, Limson G, Villanueva G, Zamora JD, Bajo-Arenas J, Bayas J, Campins M, Castellsague X, Castro M, Centeno C, Rodriguez de la Pinta ML, Torne A, Vidart JA, Chow SN, Yu MH, Cruickshank M, Hakim EA, Lewis D, Szarewski A, Ackerman R, Caldwell M, Chambers C, Chatterjee A, DeMars L, Fine P, Huh W, Klein T, Lalezari J, Leeman L, Luber S, Martens M, Peterson C, Rosen J, Seidman L, Sperling R, Stager M, Stapleton J, Waldbaum A, Wheeler CM, Colau B, Genevrois S, Martens N, Houard N, Poncelet S, Provenzano C, Tonglet A, Van Hoof C, Descamps D, Hardt K, Xhenseval V, Zahaf T, Alt E, Iskaros B, Limaye A, Luff RD, McNeeley M, Winkler B, Molijn A, Quint W, Struijk L, Van de Sandt M, Van Doorn LJ, Klugman KP, Nieminen P, Bergeron C, Eisenstein E, Karron R, Marks R, Nolan T, Tay SK., Lancet Oncol. 16(7), 2015
PMID: 26071347
Immune response to the HPV-16/18 AS04-adjuvanted vaccine administered as a 2-dose or 3-dose schedule up to 4 years after vaccination: results from a randomized study.
Romanowski B, Schwarz TF, Ferguson LM, Ferguson M, Peters K, Dionne M, Schulze K, Ramjattan B, Hillemanns P, Behre U, Suryakiran P, Thomas F, Struyf F., Hum Vaccin Immunother 10(5), 2014
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Romanowski B, Schwarz TF, Ferguson LM, Ferguson M, Peters K, Dionne M, Schulze K, Ramjattan B, Hillemanns P, Behre U, Suryakiran P, Thomas F, Struyf F., Hum Vaccin Immunother 10(5), 2014
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Forhan SE, Gottlieb SL, Sternberg MR, Xu F, Datta SD, McQuillan GM, Berman SM, Markowitz LE., Pediatrics 124(6), 2009
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Iftner T, Eberle S, Iftner A, Holz B, Banik N, Quint W, Straube AN., J. Med. Virol. 82(11), 2010
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AUTHOR UNKNOWN, 0
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WHO/ICO Information Centre on HPV and Cervical Cancer., Vaccine 25 Suppl 3(), 2007
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Clifford GM, Rana RK, Franceschi S, Smith JS, Gough G, Pimenta JM., Cancer Epidemiol. Biomarkers Prev. 14(5), 2005
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Quantifying the broader economic consequences of quadrivalent human papillomavirus (HPV) vaccination in Germany applying a government perspective framework.
Kotsopoulos N, Connolly MP, Remy V., Health Econ Rev 5(1), 2015
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Cost-effectiveness of a tetravalent human papillomavirus vaccine in Germany
Hillemanns P, Petry KU, Largeron N, McAllister R, Tolley K, Büsch K., 2009
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Ben Hadj Yahia MB, Jouin-Bortolotti A, Dervaux B., Clin Drug Investig 35(8), 2015
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Kim JJ., Lancet Infect Dis 10(12), 2010
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Kim JJ., Lancet Infect Dis 10(12), 2010
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Deshmukh AA, Chiao EY, Das P, Cantor SB., Vaccine 32(51), 2014
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Lin A, Ong KJ, Hobbelen P, King E, Mesher D, Edmunds WJ, Sonnenberg P, Gilson R, Bains I, Choi YH, Tanton C, Soldan K, Jit M., Clin. Infect. Dis. 64(5), 2017
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Would the effect of HPV vaccination on non-cervical HPV-positive cancers make the difference for its cost-effectiveness?
de Kok IM, Habbema JD, van Rosmalen J, van Ballegooijen M., Eur. J. Cancer 47(3), 2011
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de Kok IM, Habbema JD, van Rosmalen J, van Ballegooijen M., Eur. J. Cancer 47(3), 2011
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Revisiting the cost-effectiveness of universal HPV-vaccination in Denmark accounting for all potentially vaccine preventable HPV-related diseases in males and females.
Olsen J, Jorgensen TR., Cost Eff Resour Alloc 13(), 2015
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Olsen J, Jorgensen TR., Cost Eff Resour Alloc 13(), 2015
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Canvin M, Sinka K, Hughes G, Mesher D., Sex Transm Infect 93(2), 2016
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Canvin M, Sinka K, Hughes G, Mesher D., Sex Transm Infect 93(2), 2016
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Szarewski A, Skinner SR, Garland SM, Romanowski B, Schwarz TF, Apter D, Chow SN, Paavonen J, Del Rosario-Raymundo MR, Teixeira JC, De Carvalho NS, Castro-Sanchez M, Castellsague X, Poppe WA, De Sutter P, Huh W, Chatterjee A, Tjalma WA, Ackerman RT, Martens M, Papp KA, Bajo-Arenas J, Harper DM, Torne A, David MP, Struyf F, Lehtinen M, Dubin G., J. Infect. Dis. 208(9), 2013
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Szarewski A, Skinner SR, Garland SM, Romanowski B, Schwarz TF, Apter D, Chow SN, Paavonen J, Del Rosario-Raymundo MR, Teixeira JC, De Carvalho NS, Castro-Sanchez M, Castellsague X, Poppe WA, De Sutter P, Huh W, Chatterjee A, Tjalma WA, Ackerman RT, Martens M, Papp KA, Bajo-Arenas J, Harper DM, Torne A, David MP, Struyf F, Lehtinen M, Dubin G., J. Infect. Dis. 208(9), 2013
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Luyten A, Buttmann-Schweiger N, Luyten K, Mauritz C, Reinecke-Luthge A, Pietralla M, Meijer CJ, Petry KU., Int. J. Cancer 135(6), 2014
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PMID: 19586656
Paavonen J, Naud P, Salmeron J, Wheeler CM, Chow SN, Apter D, Kitchener H, Castellsague X, Teixeira JC, Skinner SR, Hedrick J, Jaisamrarn U, Limson G, Garland S, Szarewski A, Romanowski B, Aoki FY, Schwarz TF, Poppe WA, Bosch FX, Jenkins D, Hardt K, Zahaf T, Descamps D, Struyf F, Lehtinen M, Dubin G; HPV PATRICIA Study Group, Denham I, Garland S, Mindel A, O'Sullivan M, Skinner SR, Waddell R, de Carvalho N, Naud P, Teixeira JC, De Sutter P, Poppe WA, Tjalma W, Aoki FY, Diaz-Mitoma F, Dionne M, Ferguson L, Miller M, Papp K, Ramjattan B, Romanowski B, Somani R, Apter D, Astikainen S, Karppa T, Kekki M, Keranen H, Kudjoi N, Kuortti M, Kupari M, Kyha-Osterlund L, Isaksson R, Lehtinen M, Levanen H, Liljamo T, Loonberg K, Niemi L, Paavonen J, Palmroth J, Petaja T, Rekonen S, Romppanen U, Siitari-Mattila M, Tuomivaara L, Vilkki M, Belling KH, Gent T, Grubert T, Harlfinger W, Holst A, Hopker WD, Jensen-El Tobgui S, Merder G, Peters K, Schoenian S, Schulze K, Schwarz T, Wackernagel C, Boselli F, Mojana G, Salmeron J, Benitez G, Crisostomo C, Del Rosario-Raymundo R, Germar MJ, Limson G, Raymundo J, Remollino MC, Villanueva G, Villanueva S, Zamora JD, Zamora L, Bajo J, Bayas J, Campins M, Castellsague X, Castro M, Centeno C, Cruzet F, Rodriguez L, Torne A, Vidart JA, Chow SN, Yu MH, Yuan CC, Huang SC, Ho HN, Chen RJ, Lin HH, Chu TY, Angsuwathana S, Jaisamrarn U, Wilawan K, Abdulhakim E, Cruickshank M, Kitchener H, Lewis D, Pavel I, Robinson J, Szarewski A, Ackerman R, Ault K, Bennett N, Caldwell M, Chambers C, Chatterjee A, Civitarese L, Demars L, De Santis T, Downs L, Ferris D, Fine P, Gall S, Harper D, Hedrick J, Herzig W, Hiraoka M, Huh W, Kamemoto L, Klein T, Koltun W, Kong A, Lalezari J, Lee P, Leeman L, Luber S, Martens M, Michelson J, Nebel W, Peterson C, Pitts K, Rosen J, Rosenfeld W, Scutella M, Seidman L, Sperling M, Sperling R, Stager M, Stapleton J, Swenson K, Thoming C, Twiggs L, Waldbaum A, Wheeler CM, Yardley M, Zbella E, Kiviat N, Klugman KP, Nieminen P, Bergeron C, Eisenstein E, Karron R, Marks R, Nolan T, Tay SK, Albers S, Bollaerts P, Camier A, Colau B, De Breyne A, Genevrois S, Issaka Z, Martens N, Peeters P, Smoes N, Spiessens B, Tavares F, Tonglet A, Vanden-Dunghen S, Vilain AS, Ward KR, Alt E, Iskaros B, Limaye A, Liu-Jarin X, Luff RD, McNeeley M, Provenzano C, Winkler B, Molijn A, Quint W, Struijk L, Van de Sandt M, Van Doorn LJ, Greenacre M, Baronikova S, Zahaf T, David MP, Declerck L, Dupin J, Maroye JL., Lancet 374(9686), 2009
PMID: 19586656
Quadrivalent vaccine against human papillomavirus to prevent high-grade cervical lesions.
FUTURE II Study Group., N. Engl. J. Med. 356(19), 2007
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FUTURE II Study Group., N. Engl. J. Med. 356(19), 2007
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Quadrivalent vaccine against human papillomavirus to prevent anogenital diseases.
Garland SM, Hernandez-Avila M, Wheeler CM, Perez G, Harper DM, Leodolter S, Tang GW, Ferris DG, Steben M, Bryan J, Taddeo FJ, Railkar R, Esser MT, Sings HL, Nelson M, Boslego J, Sattler C, Barr E, Koutsky LA; Females United to Unilaterally Reduce Endo/Ectocervical Disease (FUTURE) I Investigators., N. Engl. J. Med. 356(19), 2007
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Efficacy of quadrivalent HPV vaccine against HPV Infection and disease in males.
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The impact of quadrivalent human papillomavirus (HPV; types 6, 11, 16, and 18) L1 virus-like particle vaccine on infection and disease due to oncogenic nonvaccine HPV types in generally HPV-naive women aged 16-26 years.
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