Table 5 |
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|
One-way sensitivity analyses comparing cervical cancer screening only and cervical cancer screening associated with a quadrivalent HPV vaccination programme |
||
|
Parameters |
ICER (£/QALYs) |
ICER (£/LYs) |
|
|
||
|
Base case |
21,059 |
34,687 |
|
Vaccine duration |
||
|
10 years |
68,417 |
116,743 |
|
10 years + booster to achieve lifetime protection |
26,782 |
44,114 |
|
20 years |
30,777 |
52,578 |
|
Multiple infections |
||
|
15% |
24,085 |
39,842 |
|
Vaccine efficacy |
||
|
85% |
25,081 |
40,831 |
|
Vaccine coverage |
||
|
50% |
21,581 |
34,426 |
|
Screening coverage rate |
||
|
-50% |
16,266. |
35,476 |
|
-10% |
19,926 |
34,681 |
|
Screening, diagnosis and treatment costs |
||
|
-20% |
21,717 |
35,771 |
|
+20% |
20,401 |
33,602 |
|
Vaccine costs |
||
|
70 £ |
19,450 |
32,036 |
|
80 £ |
22,668 |
37,337 |
|
Utilities |
||
|
25% decrease for screening utilities; 1-year duration for time with cancer |
25,600 |
|
|
25% increase in time with disease; 5-year duration for time with cancer |
19,840 |
|
|
Cancer utilities only (5 year duration) |
27,954 |
|
|
Discount rates |
||
|
0% costs; 0% medical benefit |
3,123 |
4,122 |
|
3% costs; 3% medical benefit |
17,089 |
27,066 |
|
3,5% costs; 1,5% medical benefit |
9,653 |
13,797 |
|
5% costs; 5% medical benefit |
36,618 |
68,760 |
|
Multivariate Sensitivity Analyses |
||
|
10 years duration, 50% coverage, 85% efficacy |
84,925 |
140,705 |
|
Lifetime duration, 90% coverage, 100% efficacy |
20,316 |
33,752 |
|
Changes to Screening (assuming base case assumptions for the vaccine) |
||
|
Screening every 5 years starting at age 25 |
13,449 |
36,712 |
|
Screening starting at age 26 |
20,724 |
34,441 |
|
Screening starting at age 28 |
16,527 |
34,153 |
|
Screening starting at age 30 |
13,680 |
34,989 |
|
|
||
|
Base case discount rate: 3.5% for costs and medical benefits |
||
|
Kulasingam et al. Cost Effectiveness and Resource Allocation 2008 6:4 doi:10.1186/1478-7547-6-4 |
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