Cost-Effectiveness Analysis of HPV Vaccination: Comparing the General Population with Socially Vulnerable Individuals

Abstract

<b>Background:</b> After the WHO recommended HPV vaccination of the general population in 2009, governmentsupport of HPV vaccination programs was increased in many countries. However, this policy was not implementedin Korea due to perceived low cost-effectiveness. Thus, the aim of this study was to analyze the cost-utility ofHPV vaccination programs targeted to high risk populations as compared to vaccination programs for thegeneral population. Materials and <br/><b>Methods</b>: Each study population was set to 100,000 people in a simulationstudy to determine the incremental cost-utility ratio (ICUR), then standard prevalence rates, cost, vaccinationrates, vaccine efficacy, and the Quality-Adjusted Life-Years (QALYs) were applied to the analysis. In addition,sensitivity analysis was performed by assuming discounted vaccination cost. <br/><b>Results</b>: In the socially vulnerablepopulation, QALYs gained through HPV vaccination were higher than that of the general population (Generalpopulation: 1,019, Socially vulnerable population: 5,582). The results of ICUR showed that the cost of HPVvaccination was higher for the general population than the socially vulnerable population. (General population:52,279,255 KRW, Socially vulnerable population: 9,547,347 KRW). Compared with 24 million KRW/QALYsas the social threshold, vaccination of the general population was not cost-effective. In contrast, vaccination ofthe socially vulnerable population was strongly cost-effective. <br/><b>Conclusions</b>: The results suggest the importanceand necessity of government support of HPV vaccination programs targeted to socially vulnerable populationsbecause a targeted approach is much more cost-effective. The implementation of government support for suchvaccination programs is a critical strategy for decreasing the burden of HPV infection in Korea.