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Table 5 Cost-utility analysis for base case and additional scenarios of interest

From: Health economic analysis of human papillomavirus vaccines in women of Chile: perspective of the health care payer using a Markov model

Scenarios Cervical cancer cases/deaths averteda QALYs gaineda Incremental costsb ICURa
Base case HPV-16/18 1172 / 618 848 98695 116
Base case HPV-6/11/16/18 1069 / 564 819 442981 541
HPV-16/18 prevalence; 70% cervical cancer cases due HPV types 16 and 18d 1129 / 595 816 310450 381
HPV-6/11/16/18 prevalence; 70% cervical cancer cases due HPV types 16 and18d 977 / 516 751 887321 1181
HPV-16/18 with discounting 3%e 1172 / 618 3124 -10198541 dominantc
HPV-16/18 + regular screening (every 5 years interval)f 1158 / 612 833 -1970016 dominantc
HPV-16/18 with no cross-protectiong 976 / 515 703 1620610 2305
HPV-16/18 with cross-protection assumed as the lower value of 95% CI to cervical cancer (68.4%; 95% CI: 45.7 - 82.4%) [30, 31]g 1106 / 583 799 470344 589
HPV-16/18 price as in PAHO 2012 revolving fundh 1172 / 618 848 -2197687 dominantc
HPV-6/11/16/18 vaccine price as in PAHO 2012 revolving fundh 1069 / 564 819 -1582203 dominantc
HPV-6/11/16/18 vaccine with no VE to HPV types 6 and11i 1069 / 564 772 894820 1159
HPV-16/18 waning (HPV-18 & other oncogenic HPV) after 20 years of first dose /during 5yj 955 / 487 794 568274 715
HPV-16/18 waning (HPV-18 & other oncogenic HPV) after 20 years of 1st dose/during 5y + booster dose (21 years after first dose) j, k 1170 / 617 846 797020 942
HPV-16/18, 2 dose vaccine schedulel 1172 / 618 848 -2249344 dominantc
HPV-16/18 (2 doses) waning (HPV-18 & other oncogenic HPV) after 20 years of 1st dose/during 5yj, l 955 / 487 794 -1779765 dominantc
HPV-16/18 (2 doses) waning (all HPV) after 20 years of first dose/during 5y j, l 501 / 212 681 -791887 dominantc
HPV-16/18 (2 doses) waning (HPV-18 & other oncogenic HPV) after 20 years of first dose/during 5y + booster dose (21 years after first dosej, k, l 1170 / 617 846 -1551019 dominantc
HPV-16/18 (2 doses) waning (all oncogenic HPV) after 20 years of first dose/during 5y + booster dose (21 years after first dose)j, k, l 1164 / 615 841 -1507808 dominantc
  1. aCompared to no vaccination scenario; bAdditional costs compared to no vaccination scenario; cICUR is showing a cost-saving result; dBase Case: 80% prevalence; eBase case: 6% discount; fBase case: Every 3 years interval; gBase case: CIN2/3 cross protection for bivalent vaccine 68.4% and quadrivalent vaccine 32.5%; hBase case: vaccine cost per dose 20 US dollars for both vaccines –price parity-; iBase case: 98% vaccine efficacy; jBase case: Lifetime duration of vaccine efficacy; kBase case: No booster dose; lBase case: 3 doses.
  2. Note: HPV: human papillomavirus; ICUR: incremental cost-utility ratio; VE: vaccine efficacy; PAHO: Pan American Health Organization; QALY: quality-adjusted life years.
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