Comparative cost-effectiveness analysis of two different two-dose human papillomavirus vaccines in Malaysia

Georges Van Kriekinge, Woo Yun Sohn, Syed Mohamed Al-Junid Syed Junid, Ruey Soon, Chee Meng Yong, Jing Chen, I. Heng Lee

Research output: Contribution to journalArticle

Abstract

Purpose: To comparatively evaluate the results of a 2-dose human papillomavirus (HPV) vaccination programme with the AS04-adjuvanted HPV16/18 vaccine (AS04-HPV-16/18v) or HPV-6/11/16/18 vaccine (4vHPVv), in addition to cervical cancer (CC) screening, in Malaysia. Methods: A lifetime Markov model replicating the natural history of HPV in 13-year-old girls was adapted to Malaysia to assess the impact of vaccination on pre-cancerous lesions, genital warts and CC cases, CC deaths, quality-adjusted life years (QALYs), and costs from the perspective of the Malaysian Ministry of Health. Vaccine effectiveness was based on efficacy and HPV type distribution. Both vaccines were assumed to have equal efficacy against vaccine-type HPV but differed for protection against non-vaccine types. Vaccine price parity was used and health and cost outcomes were discounted at 3%/annum. Sensitivity analyses tested the robustness of the results. Results: The model predicted that AS04-HPV-16/18v would result in 361 fewer CC cases and 115 fewer CC deaths than 4vHPVv, whereas 4vHPVv averted 4,241 cases of genital warts over the cohort's lifetime. Discounted total costs showed savings of 18.50 million Malaysian Ringgits and 246 QALYs in favour of AS04-HPV-16/18v. In one-way sensitivity analyses, the discount rate was the most influential variable for costs and QALYs, but AS04-HPV- 16/18v remained dominant throughout. A two-way sensitivity analysis to assess the longevity of cross-protection for both vaccines confirmed the base-case. Conclusions: In Malaysia, the use of AS04-HPV-16/18v, in addition to screening, was modelled to be dominant over 4vHPVv, with greater estimated CC benefits and lower costs.

Original languageEnglish
Pages (from-to)933-940
Number of pages8
JournalAsian Pacific Journal of Cancer Prevention
Volume19
Issue number4
DOIs
Publication statusPublished - 1 Apr 2018

Fingerprint

Papillomavirus Vaccines
Malaysia
Human papillomavirus 16
Uterine Cervical Neoplasms
Cost-Benefit Analysis
Vaccines
Quality-Adjusted Life Years
Condylomata Acuminata
Vaccination
Cross Protection
Human papillomavirus 11
Human papillomavirus 6
Costs and Cost Analysis
Cost Savings
Parity
Natural History
Early Detection of Cancer
Health Care Costs
Health

Keywords

  • Cost-effectiveness
  • Human papillomavirus
  • Malaysia
  • Two-dose schedule

ASJC Scopus subject areas

  • Epidemiology
  • Oncology
  • Public Health, Environmental and Occupational Health
  • Cancer Research

Cite this

Comparative cost-effectiveness analysis of two different two-dose human papillomavirus vaccines in Malaysia. / Van Kriekinge, Georges; Sohn, Woo Yun; Syed Junid, Syed Mohamed Al-Junid; Soon, Ruey; Yong, Chee Meng; Chen, Jing; Lee, I. Heng.

In: Asian Pacific Journal of Cancer Prevention, Vol. 19, No. 4, 01.04.2018, p. 933-940.

Research output: Contribution to journalArticle

Van Kriekinge, Georges ; Sohn, Woo Yun ; Syed Junid, Syed Mohamed Al-Junid ; Soon, Ruey ; Yong, Chee Meng ; Chen, Jing ; Lee, I. Heng. / Comparative cost-effectiveness analysis of two different two-dose human papillomavirus vaccines in Malaysia. In: Asian Pacific Journal of Cancer Prevention. 2018 ; Vol. 19, No. 4. pp. 933-940.
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