PhD ceremony Mr. T.A. Westra: Health-economic modelling of Human Papillomavirus vaccination

PhD ceremony: Mr. T.A. Westra, 16.15 uur, Academiegebouw, Broerstraat 5, Groningen

Dissertation: Health-economic modelling of Human Papillomavirus vaccination

Promotor(s): prof. M.J. Postma, prof. J.C. Wilschut, prof. C.A.H.H. Daemen

Faculty: Medical Sciences

Summary:

Since 2009, 12-year-old Dutch teenage girls are offered vaccination against human papillomavirus (HPV). HPV is a sexually transmitted virus that can cause cervical cancer in women. Although the available vaccines potentially provide protection against 70% of cervical cancer cases, implementation of HPV vaccination was strongly debated in The Netherlands, because of safety issues and the high costs of vaccination. Presumably due to this debate, the current vaccination coverage among teenage girls is only approximately 50%.
In this thesis, health economic models were used to assess the effectiveness and cost-effectiveness of HPV vaccination. HPV vaccination was found a highly effective and cost-effective intervention for young teenage girls. In particular, despite the relatively low vaccine uptake, approximately 50-60% of cervical cancers can be prevented by the current HPV vaccination programme. To further reduce the burden of cervical cancer, either vaccination of older girls/women or vaccination of boys could be considered. Westra found that both strategies, in combination with the current vaccination programme, are cost-effective. However, vaccination of boys is no longer cost-effective, if vaccine uptake among girls would exceed 70%. Finally, currently two registered HPV vaccines are available, a bivalent and a quadrivalent vaccine. The quadrivalent vaccine, which not only protects against cervical cancer but also against anogenital warts, was found to be slightly more cost-effective than the bivalent vaccine, despite the fact that the latter provides superior protection against cervical cancer. For well-informed decisions about the preferred vaccine, these considerations need to be taken into account during new tenders.

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