Cost-effectiveness of quadrivalent human papillomavirus (HPV) vaccination in Mexico: A transmission dynamic model-based evaluation

SummaryWe examined the potential health outcomes and cost-effectiveness of quadrivalent human papillomavirus (HPV) 6/11/16/18 vaccination strategies in the Mexican population using a multi-HPV type dynamic transmission model. Assuming similar cervical screening practices, with or without vaccination, we examined the incremental cost-effectiveness of vaccination strategies for 12 year-old females, with or without male vaccination, and temporary age 12–24 catch-up vaccination for females or both sexes. The most effective strategy therein was vaccination of 12-year-olds, plus a temporary 12–24-year-old catch-up program covering both sexes; whereby HPV 6/11/16/18-related cervical cancer, high-grade cervical precancer, and genital wart incidence was reduced by 84–98% during year 50 following vaccine introduction. Incremental cost-effectiveness ratios in the primary analyses ranged from ∼$3000 (U.S.) per quality-adjusted life year (QALY) gained for female vaccination strategies to ∼$16000/QALY for adding male vaccination with catch-up.