Cost-Effectiveness of an HPV Vaccination Program in the Postpartum Period

Area of Science:

• Public Health
• Preventative Medicine
• Gynecologic Oncology

Background:

• The postpartum period is a critical window for increasing human papillomavirus (HPV) vaccination rates among previously unvaccinated individuals.
• Low HPV vaccination rates present a significant public health challenge, contributing to preventable cervical dysplasia and cancer.

Purpose of the Study:

• To evaluate the health outcomes and cost-effectiveness of implementing an HPV vaccination program specifically targeting postpartum individuals.
• To determine if a postpartum HPV vaccination strategy is a viable and economically sound approach to cervical cancer prevention.

Main Methods:

• A Markov model simulated a cohort of 400,000 vaccine-eligible postpartum individuals in the U.S.
• Health outcomes (CIN1, CIN2+, cervical cancer) and costs were estimated using literature-derived inputs and 2024 U.S. dollars.
• Cost-effectiveness was determined by the incremental cost-effectiveness ratio (ICER) compared to a $100,000/QALY threshold.

Main Results:

• The postpartum HPV vaccination program is projected to prevent 2,575 CIN1 cases, 2,809 CIN2+ cases, and 27 early-stage cervical cancers.
• The program generated 3,476 additional quality-adjusted life years (QALYs) at an incremental cost of $79.7 million.
• The calculated ICER was $22,922/QALY, demonstrating cost-effectiveness, which held true in 99% of simulations.

Conclusions:

• A postpartum HPV vaccination program is a highly cost-effective strategy for reducing cervical dysplasia and cancer.
• This approach aligns with preventative care standards and leverages the postpartum period for vaccine completion.
• The findings underscore the postpartum period as a crucial opportunity to enhance HPV vaccine coverage and prevent HPV-related diseases.