Cost, Efficacy of HPV Vaccine in Older Women Explored
by -- Jeff Muise Updated: Oct 21st 2009
WEDNESDAY, Oct. 21 (HealthDay News) -- Giving human papillomavirus (HPV) vaccinations to older women may provide little absolute risk reduction at a high cost, according to a study in the Oct. 20 issue of the Annals of Internal Medicine.
Jane J. Kim, Ph.D., of the Harvard School of Public Health in Boston, and colleagues conducted a cost-effectiveness analysis of HPV vaccination in women ages 35 to 45 years using an existing model empirically calibrated with age-specific HPV prevalence, age-specific cervical cancer incidence, and HPV distribution. The model assumed that HPV vaccination would be added to current screening strategies (cytology or HPV DNA testing), and compared results to screening alone. The outcomes were incremental cost-effectiveness ratios calculated in 2006 U.S. dollars per quality-adjusted life-year (QALY).
The authors report that, for screening every one or two years, the cost per QALY for HPV vaccination of older women ranged from $116,950 to $272,350 for the cytology with HPV triage screening strategy, and from $193,690 to $381,590 for the combined cytology and HPV DNA testing strategy. The researchers calculated a zero probability of HPV vaccination being cost-effective for the older age group with annual or biennial screening, and a less than 5 percent probability with triennial screening.
"Given currently available information, 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," the authors conclude.
