Health and economic impact associated with a quadrivalent HPV vaccine in Italy

Objective: The aim of this study was to determine the health impact and cost-effectiveness of introducing a human papillomavirus (HPV) vaccination programme with a quadrivalent vaccine alongside the existing cervical cancer screening programme in comparison to the current context in Italy. Methods: A US Markov model was adapted to the Italian context, assuming under base case 80% vaccine coverage rate, lifetime duration of protection in a cohort of girls aged 12 years and discount rates of 1.5% and 3% for health benefits and costs, respectively, and estimating direct medical costs. Results: The HPV vaccination in association with the current screening programme would allow to avoid 1432 cases of cervical cancer (- 63.3%) and 513 deaths (- 63.4%) compared to screening only, with an incremental cost-effectiveness ratio (ICER) of €9569 per additional quality-adjusted life-year (QALY) gained. The sensitivity analysis highlighted that this model was robust to all parameters presenting uncertainties as the ICERs ranged from €2,781 to €48,122 per QALY gained. Conclusion: This study showed that HPV vaccination in adolescent girls would be a beneficial and cost-effective public health programme in Italy.