Economic evaluation of human papillomavirus vaccination in the United Kingdom

doi:10.1136/bmj.a769

Published 17 July 2008, doi:10.1136/bmj.a769
Cite this as: BMJ 2008;337:a769

Research

Economic evaluation of human papillomavirus vaccination in the United Kingdom

Mark Jit, health economist and mathematical modeller, Yoon Hong Choi, mathematical modeller, W John Edmunds, head of modelling and economics unit

¹ Modelling and Economics Unit, Centre for Infections, Health Protection Agency, London NW9 6BT

Correspondence to: M Jit mark.jit{at}hpa.org.uk

Objective To assess the cost effectiveness of routine vaccinationof 12 year old schoolgirls against human papillomavirus infectionin the United Kingdom.

Design Economic evaluation.

Setting UK.

Population Schoolgirls aged 12 or older.

Main outcome measures Costs, quality adjusted life years (QALYs),and incremental cost effectiveness ratios for a range of vaccinationoptions.

Results Vaccinating 12 year old schoolgirls with a quadrivalentvaccine at 80% coverage is likely to be cost effective at awillingness to pay threshold of £30 000 ( ${euro}$ 37 700; $59 163)per QALY gained, if the average duration of protection fromthe vaccine is more than 10 years. Implementing a catch-up campaignof girls up to age 18 is likely to be cost effective. Vaccinationof boys is unlikely to be cost effective. A bivalent vaccinewith the same efficacy against human papillomavirus types 16and 18 costing £13-£21 less per dose (dependingon the duration of vaccine protection) may be as cost effectiveas the quadrivalent vaccine although less effective as it doesnot prevent anogenital warts.

Conclusions Routine vaccination of 12 year old schoolgirls combinedwith an initial catch-up campaign up to age 18 is likely tobe cost effective in the UK. The results are robust to uncertaintyin many parameters and processes. A key influential variableis the duration of vaccine protection.

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