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Extending the Human Papillomavirus Vaccination Programme to Include Males in High-Income Countries: A Systematic Review of the Cost-Effectiveness Studies

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Abstract

Background and Objectives

Giving the human papillomavirus (HPV) vaccination to females has been shown to be cost-effective in most countries. The epidemiological evidence and economic burden of HPV-related diseases have gradually been shown to be gender neutral. Randomized clinical trials report high efficacy, immunogenicity and safety of the HPV vaccine in males aged 16–26 years. Some pioneering countries extended their HPV vaccination programme to include males, regardless of the cost-effectiveness analysis results. Nevertheless, decision makers need evidence provided by modelling and economic studies to justify the funding of mass vaccination. This systematic review aims to assess the cost-effectiveness of extending the HPV vaccination programme to include males living in high-income countries.

Methods

A systematic review of the cost-effectiveness analyses of HPV vaccination in males was performed. Data were extracted and analysed using a checklist adapted from the Consolidated Health Economic Evaluation Reporting Standards Statement.

Results

Seventeen studies and 12 underlying mathematical models were identified. Model filiation showed evolution in time from aggregate models (static and dynamic) to individual-based models. When considering the health outcomes HPV vaccines are licensed for, regardless of modelling approaches and assumptions, extending vaccinations to males is rarely found to be cost-effective in heterosexual populations. Cost-effectiveness ratios become more attractive when all HPV-related diseases are considered and when vaccine coverage in females is below 40 %.

Conclusion

Targeted vaccination of men who have sex with men (MSM) seems to be the best cost-effectiveness option. The feasibility of this strategy is still an open question, since early identification of this specific population remains difficult.

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Acknowledgments

We thank Dr Donna Willis, MD, MPH, Johns Hopkins Medical School, Baltimore, USA, for her help in editing the manuscript.

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Authors and Affiliations

  1. Department of Epidemiology, Health Economics and Prevention, Lille University Hospital, CHRU de Lille, Pôle S3P, Maison Régionale de la Recherche Clinique, 6, rue du Pr Laguesse, CS 70001, 59037, Lille Cedex, France

    Mohamed-Béchir Ben Hadj Yahia & Benoît Dervaux

  2. Department of Epidemiology, Public Health and Quality of Care, Nord-de-France University, Faculté de Médecine, Pôle Recherche, 1, Place de Verdun, 59000, Lille, France

    Mohamed-Béchir Ben Hadj Yahia, Anaïs Jouin-Bortolotti & Benoît Dervaux

  3. Academic Radiation Therapy Department, Oscar Lambret Comprehensive Cancer Center, Nord-de-France University, Lille, France

    Anaïs Jouin-Bortolotti

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  1. Mohamed-Béchir Ben Hadj Yahia
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Mohamed-Béchir Ben Hadj Yahia, Anaïs Jouin-Bortolotti and Benoît Dervaux have no conflicts of interest to declare.

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Ben Hadj Yahia, MB., Jouin-Bortolotti, A. & Dervaux, B. Extending the Human Papillomavirus Vaccination Programme to Include Males in High-Income Countries: A Systematic Review of the Cost-Effectiveness Studies. Clin Drug Investig 35, 471–485 (2015). https://doi.org/10.1007/s40261-015-0308-4

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