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J Infect Dis. 2017 Jul 15;216(2):210-219. doi: 10.1093/infdis/jix272.

Health and Economic Impact of a Tender-Based, Sex-Neutral Human Papillomavirus 16/18 Vaccination Program in the Netherlands.

Author information

1
Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam.
2
Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.

Abstract

Background:

Uptake of human papillomavirus (HPV) vaccine among girls in the Dutch immunization program has plateaued at around 60%. Vaccinating boys may be an appealing complementary strategy for the prevention of HPV-related diseases, especially since tender negotiations and reduced dosing schemes have driven down the cost of vaccination.

Methods:

We expanded a previously published Bayesian synthesis framework to account for all vaccine type-related cancers and herd immunity effects from vaccinating girls and boys. We evaluated the efficiency of vaccinating boys relative to increasing vaccine uptake among girls and assessed the cost-effectiveness of a sex-neutral program.

Results:

Vaccinating 40% of boys along with 60% of girls yielded the same gain in life-years (LYs) as increasing the uptake in girls from 60% to 80%. The incremental cost-effectiveness ratio (ICER) of vaccinating boys was €9134/LY (95% credible interval [CrI], €7323/LY-€11231/LY) under 3% discounting. The ceiling vaccination costs at which the ICER remained below the per capita gross domestic product threshold was €240 (95% CrI, €200-€280) per vaccinated boy. If girls' uptake increased to 90%, the ceiling costs decreased to €70 (95% CrI, €40-€100) per vaccinated boy.

Conclusions:

Vaccinating boys along with girls is only modestly less efficient than increasing uptake among girls and highly likely to be cost-effective under current vaccine costs and uptake in the Netherlands.

KEYWORDS:

Netherlands; cost-effectiveness analysis; human papillomavirus vaccines; sex-neutral vaccination; tender procedure

PMID:
28586466
DOI:
10.1093/infdis/jix272
[Indexed for MEDLINE]

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