A cost-effectiveness analysis of human papillomavirus vaccination of boys for the prevention of oropharyngeal cancer

Donna M. Graham, Wanrudee Isaranuwatchai, Steven Habbous, Claire De Oliveira, Geoffrey Liu, Lillian L. Siu, Jeffrey S Hoch

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

BACKGROUND Many western countries have established female human papillomavirus (HPV) vaccination programs for the prevention of cervical cancer. The quadrivalent HPV vaccine (HPV4) has proven efficacy against additional HPV-related disease in both sexes, but the cost effectiveness of male HPV vaccination remains controversial. To assess the cost effectiveness of male HPV vaccination in Canada with respect to oropharyngeal cancer (OPC), the authors performed a preliminary cost-effectiveness analysis. METHODS After an extensive literature review regarding HPV-related OPC in Canadian males, health care costs and clinical effectiveness estimates were obtained. A Markov model was used to compare the potential costs and effectiveness of HPV4 versus no vaccination among boys aged 12 years. A theoretical cohort based on a Canadian population of 192,940 boys aged 12 years in 2012 was assumed to apply the model. A 3-month cycle length was used with a "lifetime" time horizon. The outcome of the analysis was the incremental cost per quality-adjusted life-year (QALY). Sensitivity analyses were conducted on variables, including the vaccine uptake rate and vaccine efficacy. RESULTS Assuming 99% vaccine efficacy and 70% uptake, HPV4 produced 0.05 more QALYs and saved $145 Canadian dollars (CAD) per individual compared with no vaccine (QALYs and costs were discounted at 5% per year). Assuming 50% vaccine efficacy and 50% uptake, HPV4 produced 0.023 more QALYs and saved $42 CAD. The results indicated that HPV4 in males may potentially save between $8 and $28 million CAD for the theoretical cohort of 192,940 over its lifetime. CONCLUSIONS On the basis of this model, HPV vaccination for boys aged 12 years may be a cost-effective strategy for the prevention of OPC in Canada.

Original languageEnglish (US)
Pages (from-to)1785-1792
Number of pages8
JournalCancer
Volume121
Issue number11
DOIs
StatePublished - Jun 1 2015
Externally publishedYes

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Oropharyngeal Neoplasms
Cost-Benefit Analysis
Vaccination
Quality-Adjusted Life Years
Vaccines
Costs and Cost Analysis
Canada
Papillomavirus Vaccines
Uterine Cervical Neoplasms
Health Care Costs
Population

Keywords

  • computer methods and models
  • economic issues and research/treatment
  • head and neck cancer
  • mathematical methods and models
  • statistical methods and models

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Graham, D. M., Isaranuwatchai, W., Habbous, S., De Oliveira, C., Liu, G., Siu, L. L., & Hoch, J. S. (2015). A cost-effectiveness analysis of human papillomavirus vaccination of boys for the prevention of oropharyngeal cancer. Cancer, 121(11), 1785-1792. https://doi.org/10.1002/cncr.29111

A cost-effectiveness analysis of human papillomavirus vaccination of boys for the prevention of oropharyngeal cancer. / Graham, Donna M.; Isaranuwatchai, Wanrudee; Habbous, Steven; De Oliveira, Claire; Liu, Geoffrey; Siu, Lillian L.; Hoch, Jeffrey S.

In: Cancer, Vol. 121, No. 11, 01.06.2015, p. 1785-1792.

Research output: Contribution to journalArticle

Graham, DM, Isaranuwatchai, W, Habbous, S, De Oliveira, C, Liu, G, Siu, LL & Hoch, JS 2015, 'A cost-effectiveness analysis of human papillomavirus vaccination of boys for the prevention of oropharyngeal cancer', Cancer, vol. 121, no. 11, pp. 1785-1792. https://doi.org/10.1002/cncr.29111
Graham DM, Isaranuwatchai W, Habbous S, De Oliveira C, Liu G, Siu LL et al. A cost-effectiveness analysis of human papillomavirus vaccination of boys for the prevention of oropharyngeal cancer. Cancer. 2015 Jun 1;121(11):1785-1792. https://doi.org/10.1002/cncr.29111
Graham, Donna M. ; Isaranuwatchai, Wanrudee ; Habbous, Steven ; De Oliveira, Claire ; Liu, Geoffrey ; Siu, Lillian L. ; Hoch, Jeffrey S. / A cost-effectiveness analysis of human papillomavirus vaccination of boys for the prevention of oropharyngeal cancer. In: Cancer. 2015 ; Vol. 121, No. 11. pp. 1785-1792.
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abstract = "BACKGROUND Many western countries have established female human papillomavirus (HPV) vaccination programs for the prevention of cervical cancer. The quadrivalent HPV vaccine (HPV4) has proven efficacy against additional HPV-related disease in both sexes, but the cost effectiveness of male HPV vaccination remains controversial. To assess the cost effectiveness of male HPV vaccination in Canada with respect to oropharyngeal cancer (OPC), the authors performed a preliminary cost-effectiveness analysis. METHODS After an extensive literature review regarding HPV-related OPC in Canadian males, health care costs and clinical effectiveness estimates were obtained. A Markov model was used to compare the potential costs and effectiveness of HPV4 versus no vaccination among boys aged 12 years. A theoretical cohort based on a Canadian population of 192,940 boys aged 12 years in 2012 was assumed to apply the model. A 3-month cycle length was used with a {"}lifetime{"} time horizon. The outcome of the analysis was the incremental cost per quality-adjusted life-year (QALY). Sensitivity analyses were conducted on variables, including the vaccine uptake rate and vaccine efficacy. RESULTS Assuming 99{\%} vaccine efficacy and 70{\%} uptake, HPV4 produced 0.05 more QALYs and saved $145 Canadian dollars (CAD) per individual compared with no vaccine (QALYs and costs were discounted at 5{\%} per year). Assuming 50{\%} vaccine efficacy and 50{\%} uptake, HPV4 produced 0.023 more QALYs and saved $42 CAD. The results indicated that HPV4 in males may potentially save between $8 and $28 million CAD for the theoretical cohort of 192,940 over its lifetime. CONCLUSIONS On the basis of this model, HPV vaccination for boys aged 12 years may be a cost-effective strategy for the prevention of OPC in Canada.",
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AB - BACKGROUND Many western countries have established female human papillomavirus (HPV) vaccination programs for the prevention of cervical cancer. The quadrivalent HPV vaccine (HPV4) has proven efficacy against additional HPV-related disease in both sexes, but the cost effectiveness of male HPV vaccination remains controversial. To assess the cost effectiveness of male HPV vaccination in Canada with respect to oropharyngeal cancer (OPC), the authors performed a preliminary cost-effectiveness analysis. METHODS After an extensive literature review regarding HPV-related OPC in Canadian males, health care costs and clinical effectiveness estimates were obtained. A Markov model was used to compare the potential costs and effectiveness of HPV4 versus no vaccination among boys aged 12 years. A theoretical cohort based on a Canadian population of 192,940 boys aged 12 years in 2012 was assumed to apply the model. A 3-month cycle length was used with a "lifetime" time horizon. The outcome of the analysis was the incremental cost per quality-adjusted life-year (QALY). Sensitivity analyses were conducted on variables, including the vaccine uptake rate and vaccine efficacy. RESULTS Assuming 99% vaccine efficacy and 70% uptake, HPV4 produced 0.05 more QALYs and saved $145 Canadian dollars (CAD) per individual compared with no vaccine (QALYs and costs were discounted at 5% per year). Assuming 50% vaccine efficacy and 50% uptake, HPV4 produced 0.023 more QALYs and saved $42 CAD. The results indicated that HPV4 in males may potentially save between $8 and $28 million CAD for the theoretical cohort of 192,940 over its lifetime. CONCLUSIONS On the basis of this model, HPV vaccination for boys aged 12 years may be a cost-effective strategy for the prevention of OPC in Canada.

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