Cost-effectiveness analyses of catch-up vaccination against human papillomavirus (HPV) related cancers of boys and young men in Sweden

The aim of the study was to assess the cost-effectiveness of a catch-up vaccination against HPV of unvaccinated adolescent boys and young men in Sweden. Costs and health effects of HPV related cancer in such situation was compared to no vaccination of the same cohort. We used a dynamic Markov multi-state model to simulate the burden of HPV related cancer in Sweden and the effects of a catch-up vaccination in adolescent boys and young men compared to no vaccination. The model accounted for direct effects of preventing cancer in vaccinated individuals and indirect effects of vaccination through herd-immunity. The main epidemilogical outcome was the number of HPV related cancers in men and women. Costs included resource use for HPV related cancer, production loss when sick, and the cost of the vaccine and administration. Health effects were measured as quality-adjusted life years (QALY). Costs and QALYs were accumulated over the simulated time-horizon to calculate the cost per gained QALY. A HPV catch-up vaccination strategy for adolescents boys and young men would lead to a reduction in the number of HPV related cancers, both through direct and indirect effects. Vaccinating a birth cohort of boys aged 17-19 would lead to a reduction of about 510 cases of HPV related cancer over the simulated time-horizon. The corresponding figures for ages 17-26 and 17-30 were 1450 and 2080 respectively. The cost per gained QALY was EUR 50,100 for 17-19, EUR 42,800 for 17-26, and EUR 32,800 for 17-30 years old. Providing catch up vaccination to adolescent boys and young men aged 17-26 years old can be considered good value for money in a Swedish setting. The results are sensitive to changes in the vaccine effectiveness, which is greater before being exposed to the virus, and to the price of the vaccine.