Health and economic impact associated with a quadrivalent HPV vaccine in Italy.

Abstract Objective The aim of this study was to determine the health impact and cost-effectiveness of introducing a human papillomavirus (HPV) vaccination programme with a quadrivalent vaccine alongside the existing cervical cancer screening programme in comparison to the current context in Italy. Methods A US Markov model was adapted to the Italian context, assuming under base case 80% vaccine coverage rate, lifetime duration of protection in a cohort of girls aged 12 years and discount rates of 1.5% and 3% for health benefits and costs, respectively, and estimating direct medical costs. Results The HPV vaccination in association with the current screening programme would allow to avoid 1432 cases of cervical cancer (- 63.3%) and 513 deaths (- 63.4%) compared to screening only, with an incremental cost-effectiveness ratio (ICER) of EUR9569 per additional quality-adjusted life-year (QALY) gained. The sensitivity analysis highlighted that this model was robust to all parameters presenting uncertainties as the ICERs ranged from EUR2,781 to EUR48,122 per QALY gained. Conclusion This study showed that HPV vaccination in adolescent girls would be a beneficial and cost-effective public health programme in Italy.