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Comparing the cost-utility of HPV vaccination strategies in the United Kingdom Case Solution & Answer

Comparing the cost-utility of HPV vaccination strategies in the United Kingdom Case Solution 

Abstract

Different types of diseases are occurring in the world but most commonly the genital diseases are on the peak and the highest number of females are effected from it. HPV vaccine is the treatment for the cervical cancer which is the most common disease in the females and caused in the genital areas. The vaccine is tested and applied to the females to prevent from such cancer. The most important factor is to reduce the causes and possibilities of such disease in the females when they go towards the adult age.  However, the cost and outcomes of the vaccine is analyzed in the study and the Marcov model is applied to find out the results. The quantitative technique is applied and different parameters are used in the model. The aim of the study is to find the results which are still holding and the current scenario of the effectiveness that whether it is influential and valid.

  Background

HPV is the most common disease across the globe which is sexually transmitted and mostly women are affected from it. The purpose of HPV vaccination is cure from the cervical cancer and reduce its symptoms. The vaccine was first tested and provided to the females at mostly younger age when they become adult and sexually active. Initially, it was delivered first in the primary schools and mostly to the young girls. The vaccine was first in the three dose scheduled program but later the health department recommended it for two stage program. Recent researchers analyzed that two stage program is more effective rather than three stage program and the ration of disease is declined.

The disease

Cervical cancer is the sexually transmitted disease mostly occur in females. It is the type of cancer that takes place in the cervix cells, lower part of the female body that is connected through the vagina. It is disease which occurs when a female aged between 40-50 and the cancer causes on neck or some genital areas. Approximately about 2500 cases of cervical cancer was reported in UK where the age of females was mostly 18-34 and the highest ratio was in the younger aged girls. There are mostly two types of risk which is higher, one is HPV 16 and the other is HPV 18, which is mostly prevailing in England and Europe. Genital disease is the most common which is the sexual transmitted disease.

The vaccine

The HPV vaccine was started by the National Health Department in 2008 which prevent the occurrence of disease and its incidences. The program was initiated with 3 stage but later was demonstrated with stage program which reduced the number of infection. The vaccine was started with the younger girls in order to prevent the causes of such cancer in them.

Methods:

The cost utility analyses is used in the study where the vaccines is analyses with its cost and outcomes. The quantitative technique is applied to measure the outcomes and after the results are calculated and Markov model is applied in it.

Results:

The results conclude that the effectiveness of costs is dependent upon the HPV vaccinations administered. The sensitivity analysis shows that at the minimum discount rate the discounted cost for Gardasil 4 2797369.213 and at maximum discount rate, the cost for Gardasil 4 is 21400068.84. In addition, the cost of Gardasil 9 at minimum discount rate is calculated as 29603232.214, while the cost at maximum discount rate is 1246609.42. There exist differences between the total cost at the minimum and the maximum point (i.e. At Min = 162954.0008At Max = 1246609.428).

Conclusions:

The costs and the outcomes of the HPV vaccines are interrelated as the outcomes including the wellbeing, recovery, sickness and the death have different cost patterns.

 Introduction

CC is preventable and, when identified early, can be treated, and cured. However, it is still a public health issue, since it is the fourth most common cancer in women globally and causes many deaths (Bray et al., 2018). The economic burden of CC between the 5 year period from 2009/2010 to 2014/2015 cost £14 million per year on average (Stephens et al., 2020). It is estimated that, in 2019, 566 000 women were diagnosed with CC (95% UI 482 000–636 000) and approximately 280 000 women died from the disease (239 000–314 000), with projections for 2030 of substantial increases in cases and deaths (to 700 000 and 400 000, respectively) (Global Health Metrics, 2020 and World Health Organization, 2020).

Elimination of CC requires an incidence below 4 per 100 000 women-years in all countries (World Health Organization, 2014). This endeavor is aligned with the Sustainable Development Goals and fulfils many of them, such as ensuring healthy lives and promoting well-being for all ages. For this to be achieved, programmatic prevention interventions are cost-effective measures, as they aim at vaccination, early diagnosis, better treatment options and greater chance of cure.

Around 70% of HPV-related cancers are caused by HPV types 16 and 18, whilst around 90% of cases of gential warts are caused by HPV types 6 and 11 (Nour, 2009). The quadrivalent vaccine for HPV 6/11/16/18 and 9-valent vaccine for HPV 6/11/16/18/31/33/45/52/58 have been employed to prevent cervical cancer, genital warts and other vaginal precancerous lesions (Barr and Tamms, 2007; Van Damme et al., 2015).

Barr and Tamms (2007) reported efficacy of the quadrivalent vaccine at 96%-100% in preventing HPV-related complications – remaining high for at least 5 years following vaccination (it should be noted that this study took place in young women; whilst anti-HPV levels in adolescents were noted to exceed those observed in women). Reisigner et al. (2007) reported efficacy in adolescents, where more than 99.5% seroconverted using the quadrivalent vaccine – at month 18 over 91.5% of vaccine recipients were seropositive, irrespective of gender. On the other hand, previous studies of the 9-valent vaccine have reported more than 99% of individuals seroconverted, with persistence of anti-HPV responses 2.5 years after initial dosage (Van Damme et al., 2015).

There are similarities between the efficacy of the equivalent vaccine and 9-valent vaccine and the proportion of individuals sustaining adverse experiences upon vaccination (75.3% and 77.35%, respectively) (Reisinger et al., 2007; Van Damme et al., 2015).

There has been little quantitative analysis of comparison between different vaccination strategies. Hence, this paper seeks to address this gap in the literature. The objectives of this research are to : a) assess the cost effectiveness of routine vaccination of adolescent boys and girls against human papillomavirus infection in the UK; b) to design a decision tree model to consider the impact that the HPV vaccination will have on the likelihood of developing cervical cancer (all stages)………………

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