Table 1. Parameters of the model.
|
1. TRANSITION PROBABILITIES
| ||||||||
| Age | Normal-HPV HR | Normal-HPV LR | Normal -> VPH 6/11 | VPH LR -> Normal | VPH LR-Normal | Reference | ||
| 16 | 0.10 | 0.0135 | 0.018 | 0.5518 | 0.82 | |||
| 85 | 0.00045 | 0.055 | 0 | 0.135157 | 0.82 | [16,17,61] | ||
| HPV-> LSIL | Reference | |||||||
| Age | No Vaccine | Protected HR16/18 | HPV LR | Protected HPV HR | Min | Max | ||
| 15 | 0.072 | 0.0706 | 0.036 | 0.076 | 0.014 | 0.14 | ||
| 85 | 0.072 | 0.0706 | 0.036 | 0.076 | 0.14 | 0.14 | [11,13,61] | |
| HPV -Warts | Warts-Normal | Reference | ||||||
| Base Case | Max | Max | BaseCase | Max | Min | |||
| 0.300 | 0.027 | 0.57 | 0.875 | 0.875 | 0.875 | [9,61,62] | ||
| HPV-HSIL | Reference | |||||||
| Age | No Vaccination | Protected HPV 16/18 | Protected HPV HR | |||||
| 16 | 0.00357 | 0.00347 | 0.00153 | |||||
| 85 | 0.0203 | 0.0198 | 0.0087 | [13] | ||||
| LSIL-HSIL | Reference | |||||||
| Age | No Vaccine | Protected HPV 16/18 | Protected HPV HR | Max | Min | |||
| 16 | 0 | 0.017 | 0.018 | 0.000184 | 0.1485 | [13,63,64] | ||
| 85 | 0.069 | 0.068 | 0.073 | 0.000184 | 0.1485 | |||
| Age | LSIL-HPV HR | LSIL-HPV LR | LSIL-> Normal | HSIL-HPV | HSIL-LSIL | Reference | ||
| 15 | 0.082 | 0.156 | 0.1605 | 0.05 | 0.0692 | [13] | ||
| 85 | 0.086 | 0.0816 | 0.0816 | 0.05 | 0.0692 | |||
| HSIL -> CC | Reference | |||||||
| Age | No Vaccine | Protected HPV 16/18 | Protected HPV HR | |||||
| 16 | 0.000714 | 0.000412 | 0.000414 | |||||
| 85 | 0.1 | 0.0578 | 0.0579 | [13] | ||||
| Transition | Probability | Min | Max | Reference | ||||
| CC1-CC2 | 0.437 | 0.400 | 0.450 | |||||
| CC2-CC3 | 0.535 | 0.500 | 0.550 | [11,13,61] | ||||
| CC3-CC4 | 0.683 | 0.650 | 0.700 | |||||
| Symptoms | Probability | Min | Max | Reference | ||||
| CC1 | 0.15 | 0.12 | 0.18 | |||||
| CC2 | 0.23 | 0.2 | 0.25 | |||||
| CC3 | 0.6 | 0.67 | 0.73 | |||||
| CC4 | 0.90 | 0.87 | 0.93 | [13] | ||||
| Death CC | Stage I | Stage II | Stage III | Stage IV | Reference | |||
| Year 1 | 0.0377 | 0.0537 | 0.2787 | 0.5806 | ||||
| Year 2 | 0.08511 | 0.16528 | 0.26535 | 0.5 | [18] | |||
| Year 3 | 0.07406 | 0.0909 | 0.10379 | 1 | ||||
| Year 4 | 0.02993 | 0.0396 | 0.10613 | 1 | ||||
| Year 5 | 0.0239 | 0.0396 | 0.06313 | 1 | ||||
| 2. EFFICACY, COVERAGES SENSITIVITY AND DISABILITY WEIGHTS | ||||||||
| Parameter | BaseCase | Min | Max | alpha | beta | Reference | ||
| Efficacy Bivalent Vaccine against HPV 16/18 | 0.9 | 0.9 | 1 | 124 | 13.8 | [21] | ||
| Efficacy Bivalent Vaccine against HPV HR | 0.302 | 0.215 | 0.381 | - | - | [65] | ||
| Efficacy Quadrivalent Vaccine against HPV6/11 | 1 | 0.637 | 1 | - | - | [22] | ||
| Efficacy Quadrivalent Vaccine againstHPV16/18 | 0.9 | 0.338 | 0.984 | 2.9 | 0.33 | [22] | ||
| Efficacy Quadrivalent Vaccine against HPV HR | 0.25 | 0.05 | 0.409 | - | - | [66] | ||
| EfficacyTreatment LSIL/HSIL | 1 | - | - | [29,30] | ||||
| EfficacyTreatment Genital Warts | 1 | - | - | Experts | ||||
| Screening Coverage Women 25 or older | 0.7 | 0.4 | 1 | - | - | [7] | ||
| VaccineCoverage | 0.8 | 0.5 | 1 | [20] | ||||
| SensitivityScreening | 0.51 | 0.12 | 0.99 | 3.8 | .2 | [67-69] | ||
| SpecificityScreening | 0.967 | 0.91 | 0.99 | 25.9 | 6.0 | [67-69] | ||
| Treatment proportion | 0.864 | - | - | - | - | [56] | ||
| Disability Weight CC Stage I-II | 0.08 | 0.0 | 0.2 | - | - | [70] | ||
| Disability Weight CC Stage III | 0.75 | 0.65 | 0.85 | - | - | [70] | ||
| Disability Weight CC Stage IV | 0.81 | 0.70 | 0.90 | - | - | [70] | ||
| Disability Weight Death | 1 | - | - | - | - | [70] | ||
| Disability Weight other stages | 0 | - | - | - | - | [70] | ||
| 3. COSTS | ||||||||
| MedicalTreatments Costs (USD per year)[34] | Care at home costs (USD per year)[36] | |||||||
| Base Case | Min | Max | Base Case | Min | Max | |||
| LSIL | 445 | 334 | 557 | 17 | 13 | 20 | ||
| HSIL | 507 | 380 | 634 | 39 | 31 | 46 | ||
| CCI | 1751 | 1313 | 2188 | 309 | 247 | 371 | ||
| CCII | 6867 | 5150 | 8583 | 210 | 168 | 252 | ||
| CCIII | 7143 | 5357 | 8928 | 199 | 159 | 239 | ||
| CCIV | 6698 | 5024 | 8373 | 133 | 106 | 159 | ||
| Genital Warts | 77 | 58 | 96 | - | - | - | ||
| Screening | 22 | 18 | 27 | - | - | - | ||
| Follow up CC Year 1 and 2 | 346 | 259 | 432 | - | - | - | ||
| Follow up CC Year 3 to 5 | 306 | 229 | 382 | - | - | - | ||
| Follow up survivors | 357 | 268 | 446 | - | - | - | ||
| Staging | 544 | 408 | 680 | - | - | - | ||
| Transport Costs (USD per year)[38] | ||||||||
| Base Case | Min | Max | ||||||
| LSIL | 32 | 26 | 42 | |||||
| HSIL | 35 | 28 | 35 | |||||
| CCI | 961 | 196 | 5152 | |||||
| CCII | 1368 | 292 | 7675 | |||||
| CCIII | 1498 | 306 | 8032 | |||||
| CCIV | 3544 | 108 | 2847 | |||||
| Genital Warts | 11 | 6 | 9 | |||||
| Screening | 2 | 2 | 3 | |||||
| Follow up CC Year 1 to 2 | 370 | 76 | 1986 | |||||
| Follow up CC Year 3 to 5 | 204 | 42 | 1093 | |||||
| Follow up survivors | 204 | 42 | 1093 | |||||
| Staging | 807 | 36 | 54 | |||||
| Vaccination | 7 | 6 | 8 | |||||
| Vaccines Cost (USD per vaccinated Girl)[35] | ||||||||
| Base Case | Min | Max | ||||||
| BivalentVaccineCost | 214 | 133 | 487 | |||||
| QuadrivalentVaccineCost | 188 | 157 | 282 | |||||
| TotalCosts(USDperyear) | ||||||||
| Base Case | alpha | lambda | ||||||
| LSIL | 780 | 13829.76 | 1.2E-01 | |||||
| HSIL | 676 | 9.09 | 6.1E-06 | |||||
| CCI | 3717 | 9.09 | 7.0E-06 | |||||
| CCII | 9141 | 9.09 | 1.3E-06 | |||||
| CCIII | 9602 | 9.09 | 5.2E-07 | |||||
| CCIV | 11733 | 9.09 | 4.9E-07 | |||||
| Genital Warts | 104 | 9.09 | 4.0E-07 | |||||
| Screening | 24 | 9.09 | 4.6E-05 | |||||
| Follow up CC Year 1 to 2 | 850 | 9.09 | 1.9E-04 | |||||
| Follow up CC Year 3 to 5 | 587 | 9.09 | 5.6E-06 | |||||
| Follow up survivors | 826 | 9.09 | 8.1E-06 | |||||
| Staging | 1639 | 9.09 | 5.8E-06 | |||||
| Vaccination Bivalent | 258 | 9.09 | 2.9E-06 | |||||
| Vaccination Quadrivalent | 232 | 7.42 | 1.5E-05 | |||||
(Transition probabilities are annual)