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dc.contributor.authorPearson, AL
dc.contributor.authorKvizhinadze, G
dc.contributor.authorWilson, N
dc.contributor.authorSmith, M
dc.contributor.authorCanfell, K
dc.contributor.authorBlakely, T
dc.date.accessioned2020-12-22T03:11:40Z
dc.date.available2020-12-22T03:11:40Z
dc.date.issued2014-06-26
dc.identifierpii: 1471-2334-14-351
dc.identifier.citationPearson, A. L., Kvizhinadze, G., Wilson, N., Smith, M., Canfell, K. & Blakely, T. (2014). Is expanding HPV vaccination programs to include school-aged boys likely to be value-for-money: a cost-utility analysis in a country with an existing school-girl program. BMC INFECTIOUS DISEASES, 14 (1), https://doi.org/10.1186/1471-2334-14-351.
dc.identifier.issn1471-2334
dc.identifier.urihttp://hdl.handle.net/11343/257799
dc.description.abstractBACKGROUND: Similar to many developed countries, vaccination against human papillomavirus (HPV) is provided only to girls in New Zealand and coverage is relatively low (47% in school-aged girls for dose 3). Some jurisdictions have already extended HPV vaccination to school-aged boys. Thus, exploration of the cost-utility of adding boys' vaccination is relevant. We modeled the incremental health gain and costs for extending the current girls-only program to boys, intensifying the current girls-only program to achieve 73% coverage, and extension of the intensive program to boys. METHODS: A Markov macro-simulation model, which accounted for herd immunity, was developed for an annual cohort of 12-year-olds in 2011 and included the future health states of: cervical cancer, pre-cancer (CIN I to III), genital warts, and three other HPV-related cancers. In each state, health sector costs, including additional health costs from extra life, and quality-adjusted life-years (QALYs) were accumulated. The model included New Zealand data on cancer incidence and survival, and other cause mortality (all by sex, age, ethnicity and deprivation). RESULTS: At an assumed local willingness-to-pay threshold of US$29,600, vaccination of 12-year-old boys to achieve the current coverage for girls would not be cost-effective, at US$61,400/QALY gained (95% UI $29,700 to $112,000; OECD purchasing power parities) compared to the current girls-only program, with an assumed vaccine cost of US$59 (NZ$113). This was dominated though by the intensified girls-only program; US$17,400/QALY gained (95% UI: dominant to $46,100). Adding boys to this intensified program was also not cost-effective; US$128,000/QALY gained, 95% UI: $61,900 to $247,000).Vaccination of boys was not found to be cost-effective, even for additional scenarios with very low vaccine or program administration costs - only when combined vaccine and administration costs were NZ$125 or lower per dose was vaccination of boys cost-effective. CONCLUSIONS: These results suggest that adding boys to the girls-only HPV vaccination program in New Zealand is highly unlikely to be cost-effective. In order for vaccination of males to become cost-effective in New Zealand, vaccine would need to be supplied at very low prices and administration costs would need to be minimised.
dc.languageEnglish
dc.publisherBMC
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.titleIs expanding HPV vaccination programs to include school-aged boys likely to be value-for-money: a cost-utility analysis in a country with an existing school-girl program
dc.typeJournal Article
dc.identifier.doi10.1186/1471-2334-14-351
melbourne.affiliation.departmentMelbourne School of Population and Global Health
melbourne.source.titleBMC Infectious Diseases
melbourne.source.volume14
melbourne.source.issue1
dc.rights.licenseCC BY
melbourne.elementsid1174621
melbourne.contributor.authorBlakely, Antony
dc.identifier.eissn1471-2334
melbourne.accessrightsOpen Access


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