As part of the Framework for Modeling HPV Prevention (HPV-FRAME) consortium, general principles for models of HPV vaccination and for integrated models of vaccination and cervical screening will be presented. This talk will present the additional draft HPV-FRAME reporting requirements for parameters for evaluations of ‘HPV-FASTER” strategies which are broadly defined as including HPV vaccination in older women and/or men (>20-26 years) and/or combined vaccination/screening strategies where vaccination is performed in older women.
We identified distinct parameters and assumptions that are critical to specify in model-based analyses of vaccination with or without screening in women and men aged over 20-26 years. In addition to the general requirements for reporting on models of screening or integrated screening and vaccination strategies, modelling of ‘HPV-FASTER’ options should report assumptions on HPV exposure at older ages as well as the age-and type- specific assumptions about the probability of disease progression in individuals infected with HPV at older ages. The calibration and reporting on outputs for natural history models of disease at these relatively older ages will be a key focus. The role of threshold analysis on vaccine price will be discussed.
There is emerging interest in delivering HPV vaccination to older individuals, but this poses challenges for models since the population-level effectiveness and cost-effectiveness of such strategies depends not only on vaccine delivery methods and costs but also, critically on the modelling of HPV exposure (incidence) and persistence in older people. Given the probability of HPV exposure and/or progression is lower in older people than in unvaccinated adolescents, vaccination at older ages (at a given vaccine price) is less likely to be cost-effective than it is for pre-adolescents. Adequate reporting on modelling of the natural history of HPV infection in older individuals will enable assessment of quality of the analysis, and to facilitate comparison across studies.