Cost-Effectiveness Study of HPV Vaccination as a Primary Prevention Strategy for Anal Cancer in HIV-Positive Men in Chile.

Vargas Parada, C; Lennert Veerman, J

Cost-Effectiveness Study of HPV Vaccination as a Primary Prevention Strategy for Anal Cancer in HIV-Positive Men in Chile.

Vargas Parada, C

Lennert Veerman, J

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Publisher:: Elsevier BV
Publication Type:: Journal Article
Citation:: Value Health Reg Issues, 2016, 11, pp. 17-23
Issue Date:: 2016-12

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Field	Value	Language
dc.contributor.author	Vargas Parada, C https://orcid.org/0000-0002-8667-1926
dc.contributor.author	Lennert Veerman, J
dc.date.accessioned	2022-04-18T23:31:40Z
dc.date.available	2015-12-09
dc.date.available	2022-04-18T23:31:40Z
dc.date.issued	2016-12
dc.identifier.citation	Value Health Reg Issues, 2016, 11, pp. 17-23
dc.identifier.issn	2212-1099
dc.identifier.issn	2212-1102
dc.identifier.uri	http://hdl.handle.net/10453/156357
dc.description.abstract	BACKGROUND: Most anal cancers are caused by the human papilloma virus (HPV) infection. The incidence is increasing, especially in high-risk individuals such as HIV-positive men. Evidence shows that the new quadrivalent HPV vaccine reduces the rates of anal intraepithelial neoplasia among men who have sex with men. OBJECTIVE: To determine whether vaccinating against HPV-related anal cancer is cost-effective in HIV-positive men in Chile. METHODS: A cost-effectiveness analysis was conducted by constructing a cohort multistate life-table-based Markov model in MS Excel in which the prevention of HPV infection was expected to influence the incidence of anal cancer in HIV-positive men. The comparator was the current practice of no systematic HPV prevention. Estimates of the efficacy of the vaccine were obtained from a substudy of a larger randomized controlled trial, incidence rates from the Chilean Population Cancer Registries, mortality rates from the National Institute of Statistics, and disease costs from a cost-effectiveness report. A public health care sector perspective was applied. The outcome was measured in averted disability-adjusted life-years. The incremental cost-effectiveness ratio was calculated considering a lifetime horizon for costs and health outcomes. RESULTS: The estimated incremental cost-effectiveness ratio was US $138,269/ disability-adjusted life-year (95% confidence interval $95,936-$221,862). Assuming a threshold of 3 times the gross domestic product per capita, the intervention was not cost-effective. The outcome was sensitive to the vaccine price and vaccine efficacy. CONCLUSIONS: HPV vaccination in HIV-positive men from a Chilean public health care sector perspective is not cost-effective.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Elsevier BV
dc.relation.ispartof	Value Health Reg Issues
dc.relation.isbasedon	10.1016/j.vhri.2015.12.002
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1115 Pharmacology and Pharmaceutical Sciences, 1117 Public Health and Health Services, 1402 Applied Economics
dc.subject.mesh	Anus Neoplasms
dc.subject.mesh	Chile
dc.subject.mesh	Cost-Benefit Analysis
dc.subject.mesh	Humans
dc.subject.mesh	Male
dc.subject.mesh	Papillomaviridae
dc.subject.mesh	Papillomavirus Vaccines
dc.subject.mesh	Vaccination
dc.subject.mesh	Humans
dc.subject.mesh	Papillomaviridae
dc.subject.mesh	Anus Neoplasms
dc.subject.mesh	Vaccination
dc.subject.mesh	Cost-Benefit Analysis
dc.subject.mesh	Chile
dc.subject.mesh	Male
dc.subject.mesh	Papillomavirus Vaccines
dc.title	Cost-Effectiveness Study of HPV Vaccination as a Primary Prevention Strategy for Anal Cancer in HIV-Positive Men in Chile.
dc.type	Journal Article
utslib.citation.volume	11
utslib.location.activity	United States
utslib.for	1115 Pharmacology and Pharmaceutical Sciences
utslib.for	1117 Public Health and Health Services
utslib.for	1402 Applied Economics
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHERE - Centre for Health Economics Research and Evaluation
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Centre for Health Economics Research and Evaluation
utslib.copyright.status	closed_access	*
dc.date.updated	2022-04-18T23:31:39Z
pubs.publication-status	Published
pubs.volume	11

Abstract:

BACKGROUND: Most anal cancers are caused by the human papilloma virus (HPV) infection. The incidence is increasing, especially in high-risk individuals such as HIV-positive men. Evidence shows that the new quadrivalent HPV vaccine reduces the rates of anal intraepithelial neoplasia among men who have sex with men. OBJECTIVE: To determine whether vaccinating against HPV-related anal cancer is cost-effective in HIV-positive men in Chile. METHODS: A cost-effectiveness analysis was conducted by constructing a cohort multistate life-table-based Markov model in MS Excel in which the prevention of HPV infection was expected to influence the incidence of anal cancer in HIV-positive men. The comparator was the current practice of no systematic HPV prevention. Estimates of the efficacy of the vaccine were obtained from a substudy of a larger randomized controlled trial, incidence rates from the Chilean Population Cancer Registries, mortality rates from the National Institute of Statistics, and disease costs from a cost-effectiveness report. A public health care sector perspective was applied. The outcome was measured in averted disability-adjusted life-years. The incremental cost-effectiveness ratio was calculated considering a lifetime horizon for costs and health outcomes. RESULTS: The estimated incremental cost-effectiveness ratio was US $138,269/ disability-adjusted life-year (95% confidence interval $95,936-$221,862). Assuming a threshold of 3 times the gross domestic product per capita, the intervention was not cost-effective. The outcome was sensitive to the vaccine price and vaccine efficacy. CONCLUSIONS: HPV vaccination in HIV-positive men from a Chilean public health care sector perspective is not cost-effective.

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