In many countries, vaccination uptake among girls remains below the target level. Vaccinating boys may be an appealing complementary strategy for the prevention of HPV-related diseases, especially since tender negotiations and reduced dosing schemes have driven down the cost of vaccination.
We examined HPV vaccine tender-based prices published in Europe since 2007. On the basis of the latest available HPV vaccine prices, we evaluated whether extending boys is a cost-effective addition to girls’ only vaccination after adjusting for herd immunity effects. We will present health effects and economic benefits of sex-neutral vaccination in countries from different regions in Europe.
HPV vaccine tender-based prices have dropped by 60% to 80% of the ex-factory prices since 2007, the first year of implementation in tender-based settings. This has led to a substantial decrease in incremental cost-effectiveness ratios (ICERs) of girls-only vaccination compared to no vaccination; the ICERs ranged from €500 (95% CrI: 0 - 1,000) per life-year gained in Latvia to €5,000 (95% CrI: 4,000 - 6,000) per life-year gained in Austria. The ICERs of adding boys to a girls-only program showed a larger variation among countries than the ICERs of girls-only versus no vaccination, but in all countries the ICERs remained below the country-specific thresholds for a cost-effective intervention.
Vaccinating boys is only modestly less efficient than increasing uptake among girls. Sex-neutral vaccination is likely to be cost-effective under tender-based vaccine prices.