Targeted human papillomavirus vaccination for young men who have sex with men in Australia yields significant population benefits and is cost-effective

Lei Zhang, David G. Regan, Jason J. Ong, Manoj Gambhir, Eric P.F. Chow, Huachun Zou, Matthew Law, Jane Hocking, Christopher K. Fairley

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: We investigated the effectiveness and cost-effectiveness of a targeted human papillomavirus (HPV) vaccination program for young (15-26) men who have sex with men (MSM). Methods: We developed a compartmental model to project HPV epidemic trajectories in MSM for three vaccination scenarios: a boys program, a targeted program for young MSM only and the combination of the two over 2017-2036. We assessed the gain in quality-adjusted-life-years (QALY) in 190,000 Australian MSM. Results: A targeted program for young MSM only that achieved 20% coverage per year, without a boys program, will prevent 49,283 (31,253-71,500) cases of anogenital warts, 191 (88-319) person-years living with anal cancer through 2017-2036 but will only stablise anal cancer incidence. In contrast, a boys program will prevent 82,056 (52,100-117,164) cases of anogenital warts, 447 (204-725) person-years living with anal cancers through 2017-2036 and see major declines in anal cancer. This can reduce 90% low- and high-risk HPV in young MSM by 2024 and 2032, respectively, but will require vaccinating ≥84% of boys. Adding a targeted program for young MSM to an existing boys program would prevent an additional 14,912 (8479-21,803) anogenital wart and 91 (42-152) person-years living with anal cancer. In combination with a boys' program, a catch-up program for young MSM will cost an additional $AUD 6788 ($4628-11,989) per QALY gained, but delaying its implementation reduced its cost-effectiveness. Conclusions: A boys program that achieved coverage of about 84% will result in a 90% reduction in HPV. A targeted program for young MSM is cost-effective if timely implemented.

Original languageEnglish
Pages (from-to)4923-4929
Number of pages7
JournalVaccine
Volume35
Issue number37
DOIs
Publication statusPublished - 5 Sep 2017

Keywords

  • Cost-effectiveness analysis
  • Human papillomavirus
  • Mathematical modelling
  • Men who have sex with men
  • Vaccination

Cite this

@article{63322aa5523d4e4e9ed9541d38b4b8cc,
title = "Targeted human papillomavirus vaccination for young men who have sex with men in Australia yields significant population benefits and is cost-effective",
abstract = "Background: We investigated the effectiveness and cost-effectiveness of a targeted human papillomavirus (HPV) vaccination program for young (15-26) men who have sex with men (MSM). Methods: We developed a compartmental model to project HPV epidemic trajectories in MSM for three vaccination scenarios: a boys program, a targeted program for young MSM only and the combination of the two over 2017-2036. We assessed the gain in quality-adjusted-life-years (QALY) in 190,000 Australian MSM. Results: A targeted program for young MSM only that achieved 20{\%} coverage per year, without a boys program, will prevent 49,283 (31,253-71,500) cases of anogenital warts, 191 (88-319) person-years living with anal cancer through 2017-2036 but will only stablise anal cancer incidence. In contrast, a boys program will prevent 82,056 (52,100-117,164) cases of anogenital warts, 447 (204-725) person-years living with anal cancers through 2017-2036 and see major declines in anal cancer. This can reduce 90{\%} low- and high-risk HPV in young MSM by 2024 and 2032, respectively, but will require vaccinating ≥84{\%} of boys. Adding a targeted program for young MSM to an existing boys program would prevent an additional 14,912 (8479-21,803) anogenital wart and 91 (42-152) person-years living with anal cancer. In combination with a boys' program, a catch-up program for young MSM will cost an additional $AUD 6788 ($4628-11,989) per QALY gained, but delaying its implementation reduced its cost-effectiveness. Conclusions: A boys program that achieved coverage of about 84{\%} will result in a 90{\%} reduction in HPV. A targeted program for young MSM is cost-effective if timely implemented.",
keywords = "Cost-effectiveness analysis, Human papillomavirus, Mathematical modelling, Men who have sex with men, Vaccination",
author = "Lei Zhang and Regan, {David G.} and Ong, {Jason J.} and Manoj Gambhir and Chow, {Eric P.F.} and Huachun Zou and Matthew Law and Jane Hocking and Fairley, {Christopher K.}",
year = "2017",
month = "9",
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language = "English",
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Targeted human papillomavirus vaccination for young men who have sex with men in Australia yields significant population benefits and is cost-effective. / Zhang, Lei; Regan, David G.; Ong, Jason J.; Gambhir, Manoj; Chow, Eric P.F.; Zou, Huachun; Law, Matthew; Hocking, Jane; Fairley, Christopher K.

In: Vaccine, Vol. 35, No. 37, 05.09.2017, p. 4923-4929.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Targeted human papillomavirus vaccination for young men who have sex with men in Australia yields significant population benefits and is cost-effective

AU - Zhang, Lei

AU - Regan, David G.

AU - Ong, Jason J.

AU - Gambhir, Manoj

AU - Chow, Eric P.F.

AU - Zou, Huachun

AU - Law, Matthew

AU - Hocking, Jane

AU - Fairley, Christopher K.

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Y1 - 2017/9/5

N2 - Background: We investigated the effectiveness and cost-effectiveness of a targeted human papillomavirus (HPV) vaccination program for young (15-26) men who have sex with men (MSM). Methods: We developed a compartmental model to project HPV epidemic trajectories in MSM for three vaccination scenarios: a boys program, a targeted program for young MSM only and the combination of the two over 2017-2036. We assessed the gain in quality-adjusted-life-years (QALY) in 190,000 Australian MSM. Results: A targeted program for young MSM only that achieved 20% coverage per year, without a boys program, will prevent 49,283 (31,253-71,500) cases of anogenital warts, 191 (88-319) person-years living with anal cancer through 2017-2036 but will only stablise anal cancer incidence. In contrast, a boys program will prevent 82,056 (52,100-117,164) cases of anogenital warts, 447 (204-725) person-years living with anal cancers through 2017-2036 and see major declines in anal cancer. This can reduce 90% low- and high-risk HPV in young MSM by 2024 and 2032, respectively, but will require vaccinating ≥84% of boys. Adding a targeted program for young MSM to an existing boys program would prevent an additional 14,912 (8479-21,803) anogenital wart and 91 (42-152) person-years living with anal cancer. In combination with a boys' program, a catch-up program for young MSM will cost an additional $AUD 6788 ($4628-11,989) per QALY gained, but delaying its implementation reduced its cost-effectiveness. Conclusions: A boys program that achieved coverage of about 84% will result in a 90% reduction in HPV. A targeted program for young MSM is cost-effective if timely implemented.

AB - Background: We investigated the effectiveness and cost-effectiveness of a targeted human papillomavirus (HPV) vaccination program for young (15-26) men who have sex with men (MSM). Methods: We developed a compartmental model to project HPV epidemic trajectories in MSM for three vaccination scenarios: a boys program, a targeted program for young MSM only and the combination of the two over 2017-2036. We assessed the gain in quality-adjusted-life-years (QALY) in 190,000 Australian MSM. Results: A targeted program for young MSM only that achieved 20% coverage per year, without a boys program, will prevent 49,283 (31,253-71,500) cases of anogenital warts, 191 (88-319) person-years living with anal cancer through 2017-2036 but will only stablise anal cancer incidence. In contrast, a boys program will prevent 82,056 (52,100-117,164) cases of anogenital warts, 447 (204-725) person-years living with anal cancers through 2017-2036 and see major declines in anal cancer. This can reduce 90% low- and high-risk HPV in young MSM by 2024 and 2032, respectively, but will require vaccinating ≥84% of boys. Adding a targeted program for young MSM to an existing boys program would prevent an additional 14,912 (8479-21,803) anogenital wart and 91 (42-152) person-years living with anal cancer. In combination with a boys' program, a catch-up program for young MSM will cost an additional $AUD 6788 ($4628-11,989) per QALY gained, but delaying its implementation reduced its cost-effectiveness. Conclusions: A boys program that achieved coverage of about 84% will result in a 90% reduction in HPV. A targeted program for young MSM is cost-effective if timely implemented.

KW - Cost-effectiveness analysis

KW - Human papillomavirus

KW - Mathematical modelling

KW - Men who have sex with men

KW - Vaccination

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U2 - 10.1016/j.vaccine.2017.07.078

DO - 10.1016/j.vaccine.2017.07.078

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