Assessment of the cost-effectiveness of a quadrivalent HPV vaccine in Norway using a dynamic transmission model.

To assess the epidemiological and economic impact of alternative quadrivalent human papillomavirus (HPV) vaccine strategies in Norway, we adapted a previously published dynamic transmission model. Vaccination of girls and women aged 12-24 years reduced the incidence of HPV 6/11/16/18-related genital warts, cervical intraepithelial neoplasia and cervical cancer by 94, 92 and 92% by year 100, respectively. The cost-effectiveness ratio for this strategy when compared with vaccinating girls before the age of 12 years only was 63,294 Norwegian kroner (euro8272) per QALY gained. Based on this model and assumptions, implementation of a quadrivalent HPV vaccine national program in Norway could reduce the incidence of cervical cancer, cervical intraepithelial neoplasia and genital warts at a cost-effectiveness ratio within the range accepted as cost effective.