Modelling the economic effects of HPV-vaccination for adolescents of both sexes

Human Papillomavirus (HPV) is the most common sexually transmitted infection that can lead to a range of diseases. Globally, the burden of HPV-related malignant neoplasms is significant. Moscow Region is a leading region in Russia for HPV vaccine prevention with considerable accumulated experience. There is a need to consider the economic aspects, particularly the impact on the regional budget and reduction of socio-economic burden through HPV-associated diseases, taking into account regional characteristics and current epidemiological data.
Objective: To conduct a pharmacoeconomic evaluation of gender-neutral HPV vaccination among 12-year-old adolescents using a quadrivalent vaccine in Moscow Region.
Materials and Methods: The study was conducted from societal and governmental perspectives (considering direct and indirect costs) using Markov modeling for 100,000 12-year-old girls and boys. Two scenarios were considered – without vaccination and with two-dose quadrivalent HPV vaccination – followed by comparative analysis of the resulting healthcare system expenditures. The Markov cycle duration was 1 year. The analysis covered the life expectancy period of 12-year-old adolescents of both genders. The modeling considered the following conditions: cervical cancer, anal cancer, vulvar and vaginal cancer, and anogenital warts. Age-specific incidence and mortality rates corresponded to published Russian and international data. Analysis was performed without discounting.
Results: For Moscow Region, modeling of 100,000 12-year-old girls and boys over their lifetime under the current scenario (without vaccination) showed that the total number of HPV-associated diseases would be 1,648 malignant neoplasms and 2,043 anogenital warts, with 509 deaths from HPV-associated malignant neoplasms. Vaccination would prevent 1,008 new cases of HPV-associated malignant neoplasms and 303 related deaths, as well as 1,907 new cases of anogenital warts. Analysis of gender-neutral HPV vaccination showed that 330 12-year-old adolescents need to be vaccinated to prevent one death from HPV-associated malignant neoplasms. Vaccination costs to prevent one death from HPV-associated malignant neoplasms would be 5.8 million rubles. Comparative analysis results, considering only direct medical costs, show that the difference between current and modeled practices amounts to 228.9 million rubles or 67.0% at the Moscow Region level.
Conclusion: Implementation of HPV vaccination among 12-year-old adolescents using a gender-neutral approach is an economically viable strategy for Moscow Region.

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