Giorgi Kvizhinadze

Is expanding HPV vaccination programs to include school-aged boys likely to be value-for-money: a cost-utility analysis in a country with an existing school-girl program

BackgroundSimilar to many developed countries, vaccination against human papillomavirus (HPV) is provided only to girls in New Zealand and coverage is relatively low (47% in school-aged girls for dose 3). Some jurisdictions have already extended HPV vaccination to school-aged boys. Thus, exploration of the cost-utility of adding boys’ vaccination is relevant. We modeled the incremental health gain and costs for extending the current girls-only program to boys, intensifying the current girls-only program to achieve 73% coverage, and extension of the intensive program to boys.MethodsA Markov macro-simulation model, which accounted for herd immunity, was developed for an annual cohort of 12-year-olds in 2011 and included the future health states of: cervical cancer, pre-cancer (CIN I to III), genital warts, and three other HPV-related cancers. In each state, health sector costs, including additional health costs from extra life, and quality-adjusted life-years (QALYs) were accumulated. The model included New Zealand data on cancer incidence and survival, and other cause mortality (all by sex, age, ethnicity and deprivation).ResultsAt an assumed local willingness-to-pay threshold of US

Health, health inequality, and cost impacts of annual increases in tobacco tax: Multistate life table modeling in New Zealand

29,600, vaccination of 12-year-old boys to achieve the current coverage for girls would not be cost-effective, at US

Why equal treatment is not always equitable: the impact of existing ethnic health inequalities in cost-effectiveness modeling

61,400/QALY gained (95% UI

Cost-effectiveness and equity impacts of three HPV vaccination programmes for school-aged girls in New Zealand.

29,700 to

Patterns of Cancer Care Costs in a Country With Detailed Individual Data

112,000; OECD purchasing power parities) compared to the current girls-only program, with an assumed vaccine cost of US

USEOF EXPERT KNOWLEDGE ELICITATION TO ESTIMATE PARAMETERS IN HEALTH ECONOMIC DECISION MODELS

59 (NZ

Tobacco retail outlet restrictions: health and cost impacts from multistate life-table modelling in a national population

113). This was dominated though by the intensified girls-only program; US

Impact of five tobacco endgame strategies on future smoking prevalence, population health and health system costs: two modelling studies to inform the tobacco endgame

17,400/QALY gained (95% UI: dominant to

Home safety assessment and modification to reduce injurious falls in community-dwelling older adults: cost-utility and equity analysis

46,100). Adding boys to this intensified program was also not cost-effective; US

Economic evaluation of single-fraction versus multiple-fraction palliative radiotherapy for painful bone metastases in breast, lung and prostate cancer

128,000/QALY gained, 95% UI: