Novel health economic evaluation of a vaccination strategy to prevent HPV-related diseases: The BEST study

Giampiero Favato, Gianluca Baio, Alessandro Capone, Andrea Marcellusi, Silvano Costa, Giorgia Garganese, Mauro Picardo, Mike Drummond, Bengt Jonsson, Giovanni Scambia, Peter Zweifel, Francesco S. Mennini

Research output: Contribution to journalArticle

Abstract

BACKGROUND: The development of human papillomavirus (HPV)-related diseases is not understood perfectly and uncertainties associated with commonly utilized probabilistic models must be considered. The study assessed the cost-effectiveness of a quadrivalent-based multicohort HPV vaccination strategy within a Bayesian framework. METHODS: A full Bayesian multicohort Markov model was used, in which all unknown quantities were associated with suitable probability distributions reflecting the state of currently available knowledge. These distributions were informed by observed data or expert opinion. The model cycle lasted 1 year, whereas the follow-up time horizon was 90 years. Precancerous cervical lesions, cervical cancers, and anogenital warts were considered as outcomes. RESULTS: The base case scenario (2 cohorts of girls aged 12 and 15 y) and other multicohort vaccination strategies (additional cohorts aged 18 and 25 y) were cost-effective, with a discounted cost per quality-adjusted life-year gained that corresponded to &OV0556;12,013, &OV0556;13,232, and &OV0556;15,890 for vaccination programs based on 2, 3, and 4 cohorts, respectively. With multicohort vaccination strategies, the reduction in the number of HPV-related events occurred earlier (range, 3.8-6.4 y) when compared with a single cohort. The analysis of the expected value of information showed that the results of the model were subject to limited uncertainty (cost per patient=&OV0556;12.6). CONCLUSIONS: This methodological approach is designed to incorporate the uncertainty associated with HPV vaccination. Modeling the cost-effectiveness of a multicohort vaccination program with Bayesian statistics confirmed the value for money of quadrivalent-based HPV vaccination. The expected value of information gave the most appropriate and feasible representation of the true value of this program.

Original languageEnglish
Pages (from-to)1076-1085
Number of pages10
JournalMedical Care
Volume50
Issue number12
DOIs
Publication statusPublished - Dec 2012

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Keywords

  • Bayesian modeling
  • cost-effectiveness
  • HPV vaccination
  • multicohort strategy
  • uncertainty

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Favato, G., Baio, G., Capone, A., Marcellusi, A., Costa, S., Garganese, G., Picardo, M., Drummond, M., Jonsson, B., Scambia, G., Zweifel, P., & Mennini, F. S. (2012). Novel health economic evaluation of a vaccination strategy to prevent HPV-related diseases: The BEST study. Medical Care, 50(12), 1076-1085. https://doi.org/10.1097/MLR.0b013e318269e06d