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Table 1 Input data values: base-case values, associated ranges, probabilities distributions assumed and sources

From: Health economic evaluation of Human Papillomavirus vaccines in women from Venezuela by a lifetime Markov cohort model

Inputs

Value (range)

 

Source

Population data

 11-years old women cohort

264,489

-

[4]

Transition probabilities

 HPV onc regression

0.50 (0.23; 0.77)

Uniform (0.23; 0.77)

[18, 64]

 HPV onc to CIN1 progression

0.05 (0.03; 0.07)

Normal (0.03; 0.07)

[18, 64]

 CIN1 onc regression

0.36 (0.22; 0.78)

Normal (0.22; 0.78)

[18, 64]

 CIN1 onc to CIN2/3 progression

0.14 (0.08; 0.16)

Normal (0.08; 0.16)

[18, 64]

 CIN2/3 regression to no HPV

0.25 (0.23; 0.32)

Normal (0.23; 0.32)

[18, 64]

 CIN2/3 progression to cancer

0.14 (0.10; 0.15)

Normal (0.10; 0.15)

[18, 64]

 HPV low-risk CIN1

0.04 (0.03; 0.05)

Normal (0.03; 0.05)

[18, 64]

 Genital wart resistance

0.35 (0.28; 0.42)

Uniform (0.28; 0.42)

[65]

 Proportion CIN1 onc detected and treated

0.30 (0.24; 0.36)

Uniform (0.24; 0.36)

Exp. Op

 CIN1 treatment success

0.94 (0.75; 1.00)

Uniform (0.75; 1.00)

[35]

 Proportion CIN2/3 detected and treated

0.90 (0.72; 1.00)

Uniform (0.72; 1.00)

Exp. Op

 CIN2/3 treatment success

0.88 (0.70; 1.00)

Uniform (0.70; 1.00)

[35]

Utility weights

 No HPV

1.000

-

[18]

 HPV

1.000

-

[18]

 Genital Wart

0.02 (0.02; 0.02)

Uniform (0.02; 0.02)

[18]

 CIN1

1.000

-

[18]

 CIN1 detected

0.01 (0.01; 0.02)

Uniform (0.01; 0.02)

[18]

 CIN2/3

1.000

-

[18]

 CIN2/3 detected

0.01 (0.01; 0.01)

Uniform (0.01; 0.01)

[18]

 Cancer

0.27 (0.22; 0.33)

Uniform (0.22; 0.33)

[18]

 Cancer cured

0.06 (0.05; 0.07)

Uniform (0.05; 0.07)

[18]

 Death

0.000

-

[18]

Screening Characteristics

 Regular screening coverage

35%

-

[21]

 Interval between regular screening

3 years (& scenario of 5y)

-

[37]

 Irregular screening coverage

25%

-

Exp. Op

 Population without screening

40%

-

Exp. Op

 Age of initiation of screening

25 years

-

[21]

 Sensitivity to detect CIN1

0.58 (0.38; 0.56)

Normal (0.38; 0.56)

[22]

 Sensitivity to detect CIN2 and CIN3

0.61 (0.69; 0.87)

Normal (0.69; 0.87)

[22]

 Estimated positive Pap smear

0.05 (0.05; 0.06)

Uniform (0.04; 0.06)

Exp. Op

Parameters to estimate vaccine effectiveness

 Prevalence of HPV types 16 and 18 in cervical cancer

0.80 (0.64; 0.96)

Uniform (0.64; 0.96)

[15]

 Prevalence of other oncogenic HPV in cervical cancer

0.16 (0.13; 0.19)

Uniform (0.13; 0.19)

[15]

 Prevalence of HPV types 16 and 18 in CIN2/3

0.55 (0.44; 0.66)

Uniform (0.44; 0.66)

[14]

 Prevalence of other oncogenic HPV in CIN2/3

0.34 (0.27; 0.41)

Uniform (0.27; 0.41)

[14]

 Prevalence of HPV types 16 and 18 in CIN1

0.27 (0.21; 0.32)

Uniform (0.21; 0.32)

[14]

 Prevalence of other oncogenic HPV in CIN1

0.28 (0.22; 0.33)

Uniform (0.22; 0.33)

[14]

 Prevalence of HPV types 6 and 11 in CIN1

0.14 (0.11; 0.17)

Uniform (0.11; 0.17)

[14]

 Prevalence of HPV types 6 and 11 in GW

0.95 (0.76; 1.00)

Uniform (0.76; 1.00)

[33]

 Vaccine efficacy to HPV types 16 and 18 CC (Bivalent)

0.98 (0.94; 1.00)

Normal (0.94; 1.00)

[43, 44]

 Vaccine efficacy to HPV types 16 and 18 CC (Quadrivalent)

0.98 (0.94; 1.00)

Normal (0.94; 1.00)

[45]

 Vaccine efficacy to HPV types 16 and 18 CIN2/3 (Bivalent)

0.98 (0.97; 0.99)

Normal (0.97; 0.99)

[43, 44]

 Vaccine efficacy to HPV types 16 and 18 CIN2/3 (Quadrivalent)

0.98 (0.97; 0.99)

Normal (0.97; 0.99)

[45]

 Vaccine efficacy to HPV types16 and 18 CIN1 (Bivalent)

0.98 (0.97; 0.99)

Normal (0.97; 0.99)

[43, 44]

 Vaccine efficacy to HPV types16 and 18 CIN1 (Quadrivalent)

0.98 (0.97; 0.99)

Normal (0.97; 0.99)

[45]

 Vaccine efficacy to other oncogenic HPV CC (Bivalent)

0.68 (0.68; 0.68)

Normal (0.68; 0.68)

[47,48,49,50]

 Vaccine efficacy to other oncogenic HPV CC (Quadrivalent)

0.33 (0.33; 0.33)

Normal (0.33; 0.33)

[46]

 Vaccine efficacy to other oncogenic HPV CIN2/3 (Bivalent)

0.68 (0.68; 0.68)

Normal (0.68; 0.68)

[47,48,49,50]

 Vaccine efficacy to other oncogenic HPV CIN2/3 (Quadrivalent)

0.33 (0.33; 0.33)

Normal (0.33; 0.33)

[46]

 Vaccine efficacy to other oncogenic HPV CIN1 (Bivalent)

0.48 (0.48; 0.48)

Normal (0.48; 0.48)

[47,48,49,50]

 Vaccine efficacy to other oncogenic HPV CIN1 (Quadrivalent)

0.23 (0.23; 0.23)

Normal (0.23; 0.23)

[46]

 Vaccine efficacy to HPV types 6 and 11 (Quadrivalent)

0.98 (0.94; 1.00)

Normal (0.94; 1.00)

[66, 67]

 GW incidence (10-79 years)

0.17% (0.089; 0.245)

Truncated Normal (Mean; range)

[31]

Costs

 Regular screening (Bs.F)

$2,943 (2,207; 3,678)

Uniform (2,207; 3,678)

see costs section

 CIN1Onc newly detected (Bs.F)

$20,749 (15,562; 25,936)

Uniform (15,562; 25,936)

 CIN2/3 newly detected (Bs.F)

$22,230 (16,672; 27,787)

Uniform (16,672; 27,787)

 CIN1Onc det (Bs.F)

$15,284 (11,463; 19,105)

Uniform (11,463; 19,105)

 CIN2/3 det (Bs.F)

$28,355 (21,266; 35,444)

Uniform (21,266; 35,444)

 Cancer (Bs.F)

$273,788 (205,341; 342,234)

Uniform (205,341; 342,234)

 Genital Wart (Bs.F)

$9,568 (7,176; 11,960)

Uniform (7,176; 11,960)

 Vaccine bivalent (per dose) (USD)

$ 8.5

-

 Vaccine quadrivalent (per dose) USD; Scenarios 1-4

$ 8.5

-

 Vaccine quadrivalent (per dose) USD; Scenerios 5-8

$ 13.8

-

  1. Abbreviations: NIS National Institute of Statistics, MoH Ministry of Health, VEF Venezuelan bolívar fuerte, US$ United States dollar, Exp. Op expert opinion, BV bivalent, QV quadrivalent, CIN cervical intraepithelial neoplasia, CC cervical cancer, HPV human papillomavirus, VE vaccine efficacy, GW genital wart, y year