Cost-Effectiveness Analysis of the Bivalent Compared with the Quadrivalent Human Papillomavirus Vaccines in Taiwan

摘要: Abstract Objective To compare the epidemiological and economic impact of additional cross-protection against oncogenic human papillomavirus (HPV) types beyond 16/18 bivalent vaccine (BV) versus protection nononcogenic HPV 6/11 quadrivalent (QV) in Taiwan. Methods A lifetime Markov model calibrated to Taiwanese setting simulated natural history low-risk (engendering cervical intraepithelial neoplasia [CIN] 1 genital warts) high-risk CIN1, CIN2/3, cancer [CC]) infections, screening, vaccination (100% coverage) for a cohort 12-year-old girls (N = 153,000). Transition probabilities, costs, utilities were estimated from published data expert opinion. Vaccine efficacy was obtained each vaccine's respective clinical trials. Price-parity lifelong assumed both vaccines. The number CIN lesions, CC cases, deaths wart (GW) quality-adjusted life-years estimated. Costs outcomes (discounted at 3% 1.5%, respectively) compared payer's perspective. Results that BV led an additional, undiscounted, 11,484 1,779 (+34.3% vs. QV) 188 (+29.0% CC, 69 prevented with QV, while QV 4,150 GW (+71%). This resulted 768 (QALY) 11.6 million new Taiwan dollars costs saved after discounting. Conclusion Both vaccines have different increased CC-related lesions potentially because cross-protection. In setting, mass using dominate QV.