Simultaneously characterizing the comparative economics of routine female adolescent nonavalent human papillomavirus (HPV) vaccination and assortativity of sexual mixing in Hong Kong Chinese: a modeling analysis

Abstract

[...]as we evaluate the cost-benefit and cost-effectiveness of routine female adolescent nonavalent HPV vaccination for Hong Kong, we will also be simultaneously characterizing the underlying assortativity of heterosexual mixing, which in itself is an important knowledge gap on sexually transmitted infections. The decrease in age-standardized incidence of cervical cancer during the first 20 years is not caused by vaccination but instead attributed to increased screening uptake in Hong Kong since CSP was launched in 2004 (Fig. 3c; see Additional file 1 for details of cervical screening in Hong Kong). Because HPV infections take at least 20 years to progress into malignancy in most cases of cervical cancer, the differential impact of vaccine uptake between status quo and routine vaccination on cervical cancer incidence would not be apparent until 20 years after routine vaccination had begun. The current market price of fully vaccinating one girl at age 12 at the FPAHK (as of November 2017) is $284, and the tender prices for bulk purchases in Italy, Norway, South Africa, and Spain were 66–77% lower than market prices [46]. [...]we believe that the tender price of a centrally procured HPV vaccine in Hong Kong is likely to be well below the lower limit of our most conservative TVC estimate ($373) and thus provide the basis for a routine female adolescent HPV vaccination program that is both cost-beneficial and cost-effective. [...]we have not considered potential changes to cervical cancer screening (cytology is the most common primary screening method) and coverage after routine HPV vaccination begins.