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Systematic review and evidence synthesis of non-cervical human papillomavirus-related disease health system costs and quality of life estimates.
- Source :
- Sexually Transmitted Infections; Feb2019, Vol. 95 Issue 1, p28-35, 8p, 1 Diagram, 1 Chart, 2 Graphs
- Publication Year :
- 2019
-
Abstract
- <bold>Background: </bold>Many economic evaluations of human papillomavirus vaccination should ideally consider multiple disease outcomes, including anogenital warts, respiratory papillomatosis and non-cervical cancers (eg, anal, oropharyngeal, penile, vulvar and vaginal cancers). However, published economic evaluations largely relied on estimates from single studies or informal rapid literature reviews.<bold>Methods: </bold>We conducted a systematic review of articles up to June 2016 to identify costs and utility estimates admissible for an economic evaluation from a single-payer healthcare provider's perspective. Meta-analyses were performed for studies that used same utility elicitation tools for similar diseases. Costs were adjusted to 2016/2017 US$.<bold>Results: </bold>Sixty-one papers (35 costs; 24 utilities; 2 costs and utilities) were selected from 10 742 initial records. Cost per case ranges were US$124-US$883 (anogenital warts), US$6912-US$52 579 (head and neck cancers), US$12 936-US$51 571 (anal cancer), US$17 524-34 258 (vaginal cancer), US$14 686-US$28 502 (vulvar cancer) and US$9975-US$27 629 (penile cancer). The total cost for 14 adult patients with recurrent respiratory papillomatosis was US$137 601 (one paper).Utility per warts episode ranged from 0.651 to 1 (12 papers, various utility elicitation methods), with pooled mean EQ-5D and EQ-VAS of 0.86 (95% CI 0.85 to 0.87) and 0.74 (95% CI 0.74 to 0.75), respectively. Fifteen papers reported utilities in head and neck cancers with range 0.29 (95% CI 0.0 to 0.76) to 0.94 (95% CI 0.3 to 1.0). Mean utility reported ranged from 0.5 (95% CI 0.4 to 0.61) to 0.65 (95% CI 0.45 to 0.75) (anal cancer), 0.59 (95% CI 0.54 to 0.64) (vaginal cancer), 0.65 (95% CI 0.60 to 0.70) (vulvar cancer) and 0.79 (95% CI 0.74 to 0.84) (penile cancer).<bold>Conclusions: </bold>Differences in values reported from each paper reflect variations in cancer site, disease stages, study population, treatment modality/setting and utility elicitation methods used. As patient management changes over time, corresponding effects on both costs and utility need to be considered to ensure health economic assumptions are up-to-date and closely reflect the case mix of patients. [ABSTRACT FROM AUTHOR]
- Subjects :
- PAPILLOMAVIRUS disease prevention
ANAL diseases
COST effectiveness
FEMALE reproductive organ diseases
MALE reproductive organ diseases
GENITAL warts
HEAD tumors
MEDICAL care costs
NECK tumors
PAPILLOMAVIRUS diseases
QUALITY of life
RESPIRATORY infections
VAGINAL tumors
VULVAR tumors
SYSTEMATIC reviews
HUMAN papillomavirus vaccines
PENILE tumors
ANAL tumors
PREVENTION
VACCINATION
THERAPEUTICS
Subjects
Details
- Language :
- English
- ISSN :
- 13684973
- Volume :
- 95
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- Sexually Transmitted Infections
- Publication Type :
- Academic Journal
- Accession number :
- 134273000
- Full Text :
- https://doi.org/10.1136/sextrans-2018-053606