HealthDay News — Extending the age limit for human papillomavirus (HPV) vaccination up to 45 years may not be cost-effective in the United States, according to a study published online March 11 in PLOS Medicine.

Jane J. Kim, from the Harvard T. H. Chan School of Public Health in Boston, and colleagues developed 2 independent HPV microsimulation models to evaluate the cost-effectiveness of extending the upper age limit of HPV vaccination in women (from age 26 years) and men (from age 21 years) up to age 30, 35, 40, or 45 years.

The researchers found that both models projected higher costs and greater health benefits as the upper age limit of HPV vaccination increased. Vaccinating up to age 45 years had an incremental cost-effectiveness ratio (ICER) greater than a commonly accepted upper threshold of $200,000 per quality-adjusted life year (QALY) gained, compared to strategies of vaccinating women and men up to ages 30, 35, and 40 years, which were less cost-effective. ICER ranged from $315,700 to $440,600 per QALY gained when including all HPV-related outcomes and vaccinating up to age 45 years. There were major impacts on cost-effectiveness based on assumptions regarding cervical screening compliance, vaccine costs, and the natural history of noncervical HPV-related cancers.


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“HPV vaccination for adult women and men aged 30 to 45 years is unlikely to represent good value for money in the United States,” the authors write.

One author reports involvement in cervical cancer screening research, and another author receives salary support from the Cancer Institute NSW.

Abstract/Full Text