Table 2.
Parameters used in the economic modelling comparing bivalent and quadrivalent human papillomavirus (HPV) vaccines, and their sampling distribution for the probabilistic sensitivity analysis
| Parameter | Mean | Distribution | Source |
|---|---|---|---|
| Other parameters | |||
| Costs | |||
| Treatment for cervical cancer | £15 000 | Lognormal mean 15 000 (SD 9300) | Wolstenholme et al55; De Rijke et al57 |
| Relative cost of treatment (v cervical cancer): | |||
| Vulvar and vaginal cancer | 0.91 | Triangular (min 0.65, max 1.3, mode 0.75) | Hu et al56; hospital and cancer registry data |
| Anal cancer | 0.87 | Triangular (min 0.48, max 1.5, mode 0.64) | |
| Oropharyngeal cancer | 1.0 | Triangular (min 0.87, max 1.1, mode 1.0) | |
| Penile cancer | 0.77 | Triangular (min 0.65, max 1.0, mode 0.67) | |
| Treatment for anogenital warts | £112 | Normal mean 112 (SD 4) | Desai et al19 |
| Treatment for recurrent respiratory papillomatoses: | |||
| Juvenile cases | £30 000 | Lognormal mean 30 000 (SD 63 000) | Hughes et al20 and unpublished data |
| Adult cases | £4900 | Lognormal mean 4900 (SD 5400) | |
| Cytology test (liquid based) | £54 | Normal mean 54 (SD 13.5) | Curtis24; Martin-Hirsch et al42; Karnon et al43 |
| Colposcopy | £144 | Normal mean 144 (SD 36) | Martin-Hirsch et al42; Brown et al44 |
| Pre-cancerous lesion treatment | £349 | Normal mean 349 (SD 87) | Martin-Hirsch et al42; Brown et al44 |
| Vaccine price (per dose) | £84.50 | Fixed | British National Formulary41 |
| Vaccine administration (per dose) | £9.33 | Fixed | Department of Health, personal communication |
| Quality of life detriment | |||
| Treatment for | |||
| Cervical cancer | 0.285 | Triangular (min 0.24, max 0.33, mode 0.285) | Myers et al46; Gold et al47 |
| Vulvar-vaginal cancer | 0.32 | Triangular (min 0.16, max 0.52, mode 0.28) | Gold et al47 |
| Anal cancer | 0.51 | Triangular (min 0.21, max 0.83, mode 0.49) | Gold et al47 |
| Oropharyngeal cancer | 0.25 | Normal mean 0.25 (SD 0.02) | Rogers et al52 |
| Penile cancer | 0.29 | Triangular (min 0.2, max 0.38, mode 0.29) | Institute of Medicine45 |
| Recovery from cancer | 0.0305 | Triangular (min 0, max 0.061, mode 0.0305) | Klee et al49 50; Korfage et al51 |
| Positive cytology result | 0.025 | Normal mean 0.025 (SD 0.00625) | Jit et al16 |
| Positive cervical intraepithelial neoplasia result: | |||
| Grade I | 0.012 | Normal mean 0.012 (SD 0.003) | Jit et al16 |
| Grade II | 0.007 | Normal mean 0.007 (SD 0.00175) | |
| Grade III | 0.054 | Normal mean 0.054 (SD 0.00135) | |
| Episode of anogenital warts | 0.018 | Normal mean 0.018 (SD 0.0059) | Woodhall et al18 |
| Episode of recurrent respiratory papillomatosis | 1.30 | Lognormal mean 1.30 (SD 1.56) | Bishai et al58 |
| Time spent receiving treatment for cancer (years) | 0.116 | Lognormal mean 0.116 (SD 0.36) | Hospital Episode Statistics |
| True proportion of cancers due to HPV 16 and 18 | |||
| Squamous cell carcinomas | 80% | Normal mean 0.80 (SD 0.027) | Howell-Jones et al17 |
| Adenocarcinomas | 86% | Normal mean 0.86 (SD 0.040) | |
| Additional risk of mild smear if HPV 6 or 11 positive | 5.4% | Normal mean 0.54 (SD 0.030) | Chapman et al21 |
| Risk of colposcopy after mild smear if HPV 6 or 11 positive | 2.3% | Normal mean 0.023 (SD 0.0072) | Chapman et al21 |
| Proportion of cancers due to HPV: | |||
| Vulvar-vaginal cancer | 47% | Beta (p 690, q 780) | Literature review (see appendix 1 on bmj.com) |
| Anal cancer | 42% | Beta (p 55, q 77) | |
| Oropharyngeal | 84% | Beta (p 800, q 150) | |
| Penile | 36% | Beta (p 340, q 620) | |
| Proportion of HPV attributed cancers due to HPV 16 or 18 | |||
| Vulvar-vaginal cacer | 74% | Beta (p 77, q 27) | Literature review (see appendix 1 on bmj.com) |
| Anal cancer | 90% | Beta (p 95, q 11) | |
| Oropharyngeal cancer | 93% | Beta (p 760, q 56) | |
| Penile cancer | 89% | Beta (p 300, q 37) | |