Table 8 Impact of varying vaccine price, genital warts inputs and HPV type distributions
Description of sensitivity analysis | Difference in lifetime cases of cancer | Difference in discounted lifetime healthcare cost | Difference in discounted lifetime QALY | Incremental cost per QALY gained* |
|---|---|---|---|---|
|  | (A – B) | (A – B) | (A – B) |  |
Base Case | −48 | -$683 107 | 1 | A Dominates B |
Vaccine price | ||||
HPV-6/11/16/18 vaccine price decreased to $98 per dose | −48 | -$83 107 | 1 | A Dominates B |
HPV-6/11/16/18 vaccine price decreased to $97 per dose | −48 | $216 893 | 1 | $145 773 B lower lifetime cost; A saves more QALYs |
HPV distribution | ||||
Changed to North American data | −41 | -$760 577 | −13 | $59 359 A lower lifetime cost; B saves more QALYs |
Proportion of 6 / 11 in genital warts increased to 90% | −48 | -$496 855 | −19 | $26 015 A lower lifetime cost; B saves more QALYs |
Impact of herd immunity on male genital wart lesions | ||||
Double incidence of GW, assume herd immunity impact of 20% | −48 | -$564 421 | −8 | $68 100 A lower lifetime cost; B saves more QALYs |
Double incidence of GW, assume herd immunity impact of 30% | −48 | -$461 020 | −18 | $25 388 A lower lifetime cost; B saves more QALYs |
Double incidence of GW, assume herd immunity impact of 40% | −48 | -$355 588 | −28 | $12 629 A lower lifetime cost; B saves more QALYs |
Double incidence of GW, assume herd immunity impact of 50% | −48 | -$248 084 | −38 | $6 481 A lower lifetime cost; B saves more QALYs |
Double incidence of GW, assume herd immunity impact of 90% | −48 | $203 554 | −80 | B Dominates A |
Incidence of GW*2.2, assume herd immunity impact of 20% | −48 | -$538 277 | −10 | $52 037 A lower lifetime cost; B saves more QALYs |
Incidence of GW*2.2, assume herd immunity impact of 30% | −48 | -$414 878 | −22 | $18 739 A lower lifetime cost; B saves more QALYs |
Incidence of GW*2.2, assume herd immunity impact of 40% | −48 | -$288 911 | −34 | $8 473 A lower lifetime cost; B saves more QALYs |
Incidence of GW*2.2, assume herd immunity impact of 50% | −48 | -$160 318 | −46 | $3 468 A lower lifetime cost; B saves more QALYs |
Incidence of GW*2.2, assume herd immunity impact of 90% | −48 | $381 563 | −96 | B Dominates A |
Genital warts incidence | ||||
+25% | −48 | −449 523 | −20 | $22 485 A lower lifetime cost; B saves more QALYs |
+10% | −48 | −589 284 | −7 | $82 535 A lower lifetime cost; B saves more QALYs |
−10% | −48 | −777 456 | 10 | A Dominates B |
−25% | −48 | −919 979 | 23 | A Dominates B |
Genital warts cost | ||||
Increased to 125% of base case | −48 | -$444 754 | 1 | A Dominates B |
Decreased to 75% of base case | −48 | -$924 966 | 1 | A Dominates B |
Genital warts disutility | ||||
Increased to 125% of base case | −48 | -$683 107 | −21 | $32 749 A lower lifetime costs; B saves more QALYs |
Decreased to 75% of base case | −48 | -$683 107 | 24 | A Dominates B |
0.041, Drolet et al. | −48 | -$683 107 | −95 | $7 170 A lower lifetime costs; B saves more QALYs |