Adding a quadrivalent human papillomavirus vaccine to the UK cervical cancer screening programme: A cost-effectiveness analysis

Shalini L Kulasingam¹ , Steve Benard² , Ruanne V Barnabas³^,4 , Nathalie Largeron² and Evan R Myers¹

¹Dept. of Obstetrics and Gynecology, Duke University, Durham, NC 27705, USA

²sanofi pasteur MSD, Lyon, 69007, France

³Cancer Epidemiology Unit, University of Oxford, Oxford, OX3 7LF, UK

⁴HIV Vaccines Trials Network, Fred Hutchinson Research Center, Seattle, WA, USA

author email corresponding author email

Cost Effectiveness and Resource Allocation 2008, 6:4doi:10.1186/1478-7547-6-4


Published:	15 February 2008

Abstract

Background

We assessed the cost-effectiveness of adding a quadrivalent (6/11/16/18) human papillomavirus (HPV) vaccine to the current screening programme in the UK compared to screening alone.

Methods

A Markov model of the natural history of HPV infection incorporating screening and vaccination was developed. A vaccine that prevents 98% of HPV 6, 11, 16 and 18-associated disease, with a lifetime duration and 85% coverage, in conjunction with current screening was considered.

Results

Vaccination with screening, compared to screening alone, was associated with an incremental cost-effectiveness ratio of £21,059 per quality adjusted life year (QALY) and £34,687 per life year saved (LYS). More than 400 cases of cervical cancer, 6700 cases of cervical intraepithelial neoplasia and 4750 cases of genital warts could be avoided per 100,000 vaccinated girls. Results were sensitive to assumptions about the need for a booster, the duration of vaccine efficacy and discount rate.

Conclusion

These analyses suggest that adding a quadrivalent HPV vaccine to current screening in the UK could be a cost-effective method for further reducing the burden of cervical cancer.