Cost-Effectiveness of HPV Vaccination and Cervical Cancer Screening in Women Aged 30+ Years in the U.S.
2009
The objective of the study was to assess the health and economic outcomes of HPV vaccination in older U.S. women. The authors conducted a cost-effectiveness analysis with an empirically calibrated model using data from published literature; interventions included HPV vaccination added to screening strategies that differ by test (cytology or HPV DNA testing), frequency, and start age versus screening alone.
They found that in the context of annual or biennial screening, HPV vaccination of women aged 35 to 45 years ranged from $116 950 to $272 350 per QALY for cytology with HPV DNA testing for triage of equivocal results and from $193 690 to $381 590 per QALY for combined cytology and HPV DNA testing, depending on age and screening frequency. The probability of HPV vaccination being cost-effective for women aged 35 to 45 years was 0% with annual or biennial screening and less than 5% with triennial screening, at thresholds considered good value for money.
Given currently available information, they therefore concluded that the effectiveness of HPV vaccination for women older than 30 years who are screened seems to be small. Compared with current screening that uses sensitive HPV DNA testing, HPV vaccination is associated with less attractive cost-effectiveness ratios in this population than those for other, well accepted interventions in the United States.
Source:
Kim JJ, Ortendahl J, Goldie SJ. Cost-Effectiveness of Human Papillomavirus Vaccination and Cervical Cancer Screening in Women Older Than 30 Years in the United States. Annals of Internal Medicine 2009; 151 (8): 538-545. https://doi.org/10.7326/0003-4819-151-8-200910200-00007
Not open access.