"A vaccine targeting human papillomavirus (HPV) types 16 and 18, which are associated with 80 percent of anal cancers, is efficacious in men. High-risk populations such as men who have sex with men (MSM) might especially benefit from vaccination," explained the study author, who aimed to estimate the cost-effectiveness of HPV vaccination of US MSM.
Kim constructed decision-analytic models to estimate the direct health and economic outcomes of HPV vaccination (against types 6, 11, 16 and 18) for HPV-related anal cancer and genital wart prevention. Age at vaccination (12 years, 20 years and 26 years), previous exposure to vaccine-targeted HPV types and prevalence of HIV-1 were the model parameters that were varied. Kim used the models to conduct sensitivity analyses, including duration of vaccine protection; vaccine cost; and burden of anal cancer and genital warts.
In the scenario of HPV vaccination of MSM at age 12 without previous HPV exposure, compared with no vaccination, vaccination cost $15,290 per quality-adjusted life-year gained. In scenarios where MSM are vaccinated at age 20 or 26, after HPV exposure, the cost-effectiveness ratios worsened but were less than $50,000 per quality-adjusted life-year under most scenarios. For example, HPV vaccination of MSM at age 26 cost $37,830 per quality-adjusted life-year when assuming 50 percent of MSM previously exposed to all vaccine-targeted HPV types. Outcomes were most sensitive to variations in anal cancer incidence, duration of vaccine protection and HIV prevalence in MSM.
"HPV vaccination of MSM is likely to be a cost-effective intervention for the prevention of genital warts and anal cancer," Kim concluded.
11/30/10
UNITED STATES: Targeted HPV Vaccination of MSM in the USA: A Cost-Effectiveness Modeling Analysis
Source: Lancet Infectious Diseases Vol. 10; No. 12: P. 845-852 (12..10):: Jane J. Kim, PhD; Courtesy of the CDC National Center for HIV, STD, and TB Prevention