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• W2279465061 abstract "Rationale: A quadrivalent human papillomavirus (HPV 6,11,16&18) vaccine, now available in Europe, will allow to prevent cervical cancer (CC), cervical lesions (CIN) and genital warts (GW). Reliable epidemiological and economical models are required to assess the impact of this new vaccine and country specific models are often necessary to produce accurate results. Calibration is an important step in the model adaptation as it evaluates the degree of correspondence between epidemiological outcomes predicted by the model and those really observed. Objective: The objective of this study was to give an overview of the efforts undertaken to adapt and to validate a markov model to the German setting in order to assess the clinical and economical impact of adding a quadrivalent HPV (6,11,16&18) vaccine alongside current cervical screening programme. Methodology: A 21-state Markov Model, developed to examine the epidemiological and economic effects of a universal HPV (6,11,16&18) vaccination in the UK, was adapted to the German situation. The model was first adapted structurally to reflect the screening and treatment pathways in Germany. In a second step the model was populated with German epidemiological, clinical and economic data, derived from two local burden of disease studies, published literature and two clinical trials (FUTURE I and II). Then, a calibration exercise was performed to check the consistency of the model, considering important epidemiological endpoints such as lifetime risks of cervical cancer and deaths due to cervical cancer before screening implementation and age-specific cervical cancer and mortality in the current screening strategy. At least, a vaccine that would prevent 100% of HPV 6, 11, 16 and 18-associated disease, with lifetime duration and 80% coverage, given to girls at age 12 in conjunction with current screening was compared to screening alone using cost per life-year (LY) and quality-adjusted life-year (QALY). Results: In the absence of screening, the model predicts a lifetime risk of cervical cancer of 3.1% and a lifetime mortality risk of 1.08%. These results are similar to the findings of Siebert et al (3% and 1% respectively). In a screened population, the model predicted an age-specific cervical cancer incidence values and an age standardised incidence rate for cervical cancer similar to the observed ones from the epidemiological cancer registry of the Saarland. Vaccination alongside the current screening programme is associated with an incremental cost-effectiveness ratio (ICER) of 11,219/QALY compared to screening alone. Conclusions: The model is able to replicate main epidemiological endpoints for Germany and suggest that adding a quadrivalent HPV (6,11,16&18) vaccine to the current screening programme may be a cost-effective intervention for further reducing the burden of cervical cancer, cervical lesions and genital warts in this country." @default.
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• W2279465061 date "2007-06-13" @default.
• W2279465061 modified "2023-09-26" @default.
• W2279465061 title "Cost-Effectiveness Analysis of a Quadrivalent Hpv-(6,11,16&18) Vaccine: Adaptation and Calibration of a Markov Model to Germany" @default.
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