Public health impact and cost-effectiveness of catch-up 9-valent HPV vaccination of individuals through age 45 years in the United States
| Autor: | Smita Kothari, Vincent J. Daniels, Elamin H. Elbasha, Salome Samant, Cody Palmer, Vimalanand S. Prabhu, Craig S. Roberts |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Cost effectiveness Advisory committee Cost-Benefit Analysis 030231 tropical medicine Immunology Uterine Cervical Neoplasms 03 medical and health sciences 0302 clinical medicine disease transmission models Environmental health Immunology and Allergy Medicine Humans 030212 general & internal medicine Papillomavirus Vaccines Human papillomavirus health care economics and organizations Pharmacology business.industry Public health Papillomavirus Infections Vaccination virus diseases Hpv vaccination Middle Aged Nutrition Surveys United States Immunization Female Cost-effectiveness Public Health Quality-Adjusted Life Years business Research Article Research Paper 9-valent human papillomavirus (HPV) vaccine |
| Zdroj: | Human Vaccines & Immunotherapeutics article-version (VoR) Version of Record |
| ISSN: | 2164-554X |
| Popis: | The Advisory Committee on Immunization Practices (ACIP) recommended catch-up 9-valent Human Papillomavirus (HPV) vaccination through age 26 years, and shared clinical decision-making for adults aged 27–45 years, compared with catch-up through age 26 years and 21 years for females and males, respectively (status quo; pre-June-2019 recommendations). This study assessed the public health impact and cost-effectiveness of expanded catch-up vaccination through age 45 years (expanded catch-up) compared with status quo. We used an HPV dynamic transmission infection and disease model to assess disease outcomes and incremental cost-effectiveness ratio (ICER) of expanded catch-up compared with status quo. Costs (2018 USD), calculated from a healthcare sector perspective, and quality-adjusted life years (QALY) were discounted at 3% annually. Historical vaccination coverage was estimated using NIS-TEEN survey data (NHANES data for sensitivity analysis). Alternative scenario analyses included restricting upper age of expanded catch-up through 26 years (June-2019 ACIP recommendation), 29 years, and further 5-year increments. Our results show expanded catch-up vaccination would prevent additional 37,856 cancers, 314,468 cervical intraepithelial neoplasia-2/3s, 1,743,461 genital warts, and 10,698 deaths compared with status quo over 100 years at cost of $141,000/QALY. With NHANES coverage, the ICER was $96,000/QALY. The June-2019 ACIP recommendation also provided public health benefits with an ICER of $117,000/QALY, compared with status quo. The ICER for expanded vaccination through age 34 years was $107,000/QALY. Expanding catch-up vaccination program through age 45 years-old in the US is expected to provide public health benefits, and cost-effectiveness improves with expanding catch-up through age 34. |
| Databáze: | OpenAIRE |
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