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Table 8 Impact of varying vaccine price, genital warts inputs and HPV type distributions

From: Modeling the impact of the difference in cross-protection data between a human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine and a human papillomavirus (HPV)-6/11/16/18 vaccine in Canada

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
  1. A – Vaccine A - HPV-16/18 AS04-adjuvanted vaccine.
  2. B - Vaccine B: HPV-6/11/16/18 vaccine.
  3. QALYs – Quality adjusted life years.
  4. * A Dominates B – HPV-16/18 AS04-adjuvanted vaccine associated with lower lifetime costs to the healthcare system than HPV-6/11/16/18 vaccine; HPV-16/18 AS04-adjuvanted vaccine also saves more QALYs than HPV-6/11/16/18 vaccine.
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