Cost-Utility of a Two-Dose Human Papillomavirus Vaccination Programme Added to Cervical Cancer Screening Compared with Cervical Cancer Screening Alone in Korea

Document Type : Research Articles


1 Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-ro 173 Beon-gil, Bundang-gu, 463-707 Seongnam, Korea.

2 Seoul St. Mary's Hospital, The Catholic University of Korea, 505 Banpo-dong, Seocho-gu, 137-701 Seoul, Korea.

3 GSK, 9th Floor, LS Yong-san Tower, 92 Hangangdae-ro, Yongsan-gu, 140-012 Seoul, Korea.

4 GSK, 23 Rochester Park, Singapore 139234, Singapore.

5 Present address, Gilead Sciences, Hong Kong, China.

6 GSK, 20 Avenue Fleming, 1300 Wavre, Belgium.

7 Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro Gangnam-gu, Seoul, Korea.


Background: Cervical cancer is caused by the human papillomavirus and is a leading cause of cancer death among
young Korean women. Current screening programmes could benefit from the addition of HPV vaccination into their
schedule to help reduce disease burden. Two-dose vaccination schedules targeting HPV types 16 and 18, which are
responsible for most cervical cancer cases, have recently been approved. Of the two available vaccines, AS04-adjuvanted
HPV16/18 vaccine (AS04-HPV16/18v) provides greater protection against non-vaccine oncogenic HPV, while
HPV-6/11/16/18 vaccine (4vHPVv) provides protection against genital warts. Methods: The health and economic
consequences of introducing a two-dose HPV vaccination programme in 12-year-old girls together with screening were
assessed in the Korean healthcare setting using a previously-published Markov model. Results: Compared with screening
alone, AS04-HPV16/18v was cost-effective (incremental cost-effectiveness ratio below and within the Korean Won
[KRW] 20-30 million treshold). When comparing the two vaccines, at 3% discount rate, AS04-HPV16/18v dominated
4vHPVv (i.e., provided 174 more quality-adjusted life-years (QALYs), 304 more life-years (LYs) and cost-savings of
KRW 980 million). At a 5% discount rate, AS04-HPV16/18v provided comparable QALYs (albeit 5 fewer), 105 more
LYs and cost-savings of KRW 292 million compared with 4vHPVv. Results were particularly sensitive to the discount
rate used, as the health benefits of preventing cervical cancer are observed much later than those of preventing genital
warts. Conclusion: For the Korean setting, HPV vaccination with a two-dose schedule is a cost-effective option, and
AS04-HPV16/18v is likely to offer better health outcomes at a cost-saving compared with 4vHPVv.


Main Subjects