An estimate of the public health impact and cost-effectiveness of universal vaccination with a 9-valent HPV vaccine in Germany

ABSTRACT

Introduction: Since 2007, the German Standing Vaccination Committee recommends HPV vaccination for girls aged 12–17 with a 2- (Cervarix®) or 4-valent (Gardasil®) vaccine. A 9-valent vaccine (Gardasil 9®) recently received a European market authorization in 2015.

Methods: A dynamic transmission model was calibrated to the German setting and used to estimate costs and QALYs associated with vaccination strategies.

Results: Compared to the current vaccination program, the 9-valent vaccine extended to boys shows further reductions of 24% in the incidence of cervical cancer, 30% and 14% in anal cancer for males and females, as well as over a million cases of genital warts avoided after 100 years. The new strategy is associated with an ICER of 22,987€ per QALY gained, decreasing to 329€ when considering the vaccine switch for girls-only.

Conclusion: Universal vaccination with the 9-valent vaccine can yield significant health benefits when compared to the current program.

KEYWORDS:

• Cost-effectiveness
• Germany
• HPV
• cervical cancer
• vaccination

Declaration of interest

N Largeron and M Uhart are employees of SPMSD. KU Petry has an institutional grant from SPMSD and works as an occasional advisor for SPMSD and Roche Diagn. J Jacob, F Blanc and D Anger are employees of Mapi Group, which received funding from SPMSD to conduct this study. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Notes

1. Converted to Euros. Rate: 1.35869. Reference: http://www.xe.com/ date: 06/01/2016 17:00 UTC and rounded to 40,000.

Additional information

Funding

This manuscript was funded by Sanofi Pasteur MSD (SPMSD).