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Published in: The European Journal of Health Economics 6/2019

01-08-2019 | Human Papillomavirus | Original Paper

Economic burden of HPV9-related diseases: a real-world cost analysis from Italy

Authors: F. S. Mennini, Gianluca Fabiano, G. Favato, P. Sciattella, P. Bonanni, C. Pinto, A. Marcellusi

Published in: The European Journal of Health Economics | Issue 6/2019

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Abstract

Introduction

The objectives of this study were to estimate the economic burden of HPV in Italy, accounting for total direct medical costs associated with nine major HPV-related diseases, and to provide a measure of the burden attributable to HPV 6, 11, 16, 18, 31, 33, 45, 52, 58 infections.

Methods

A cost-of-illness incidence-based model was developed to estimate the incidences and costs of invasive cervical cancer, cervical dysplasia, cancer of the vulva, vagina, anus, penis, oropharyngeal, anogenital warts, and recurrent respiratory papillomatosis (RRP) in the context of the Italian National Health System (NHS). We used data from hospital discharge records (HDRs) of an Italian region and conducted a systematic literature review to estimate the lifetime cost per case, the number of incident cases, the prevalence of HPV9 types. Costs of therapeutic options not included in the diagnosis-related group (DRG) tariffs were estimated through a scenario analysis.

Results

In 2018, the total annual direct costs were €542.7 million, with a range of €346.7–€782.0 million. These costs could increase considering innovative therapies for cancer treatment (range €16.2–€37.5 million). The fraction attributable to the HPV9 genotypes without innovative cancers treatment was €329.5 million, accounting for 61% of the total annual burden of HPV-related diseases in Italy. Of this amount, €135.9 million (41%) was related to men, accounting for 64% of the costs associated with non-cervical conditions.

Conclusions

The infections by HPV9 strains and the economic burden of non-cervical HPV-related diseases in men were found to be the main drivers of direct costs.
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Literature
1.
go back to reference Goldstone, S., et al.: Prevalence of and risk factors for human papillomavirus (HPV) infection among HIV-seronegative men who have sex with men. J. Infect. Dis. 203(1), 66–74 (2011)CrossRefPubMedPubMedCentral Goldstone, S., et al.: Prevalence of and risk factors for human papillomavirus (HPV) infection among HIV-seronegative men who have sex with men. J. Infect. Dis. 203(1), 66–74 (2011)CrossRefPubMedPubMedCentral
2.
go back to reference McQuillan, G.M., et al.: Prevalence of HPV in adults aged 18-69: United States, 2011–2014. US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, MD (2017) McQuillan, G.M., et al.: Prevalence of HPV in adults aged 18-69: United States, 2011–2014. US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, MD (2017)
3.
go back to reference Favato, G., et al.: A novel method to value real options in health care: the case of a multicohort human papillomavirus vaccination strategy. Clin. Ther. 35(7), 904–914 (2013)CrossRefPubMed Favato, G., et al.: A novel method to value real options in health care: the case of a multicohort human papillomavirus vaccination strategy. Clin. Ther. 35(7), 904–914 (2013)CrossRefPubMed
4.
5.
go back to reference Walboomers, J.M., et al.: Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J. Pathol. 189(1), 12–19 (1999)CrossRefPubMed Walboomers, J.M., et al.: Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J. Pathol. 189(1), 12–19 (1999)CrossRefPubMed
6.
go back to reference Chaturvedi, A.K.: Beyond cervical cancer: burden of other HPV-related cancers among men and women. J. Adolesc. Health 46(4 Suppl), S20–S26 (2010)CrossRefPubMed Chaturvedi, A.K.: Beyond cervical cancer: burden of other HPV-related cancers among men and women. J. Adolesc. Health 46(4 Suppl), S20–S26 (2010)CrossRefPubMed
7.
go back to reference Koutsky, L.A., Galloway, D.A., Holmes, K.K.: Epidemiology of genital human papillomavirus infection. Epidemiol. Rev. 10, 122–163 (1988)CrossRefPubMed Koutsky, L.A., Galloway, D.A., Holmes, K.K.: Epidemiology of genital human papillomavirus infection. Epidemiol. Rev. 10, 122–163 (1988)CrossRefPubMed
8.
go back to reference Armstrong, L.R., Derkay, C.S., Reeves, W.C.: Initial results from the national registry for juvenile-onset recurrent respiratory papillomatosis. RRP Task Force. Arch. Otolaryngol. Head Neck Surg. 125(7), 743–748 (1999)CrossRefPubMed Armstrong, L.R., Derkay, C.S., Reeves, W.C.: Initial results from the national registry for juvenile-onset recurrent respiratory papillomatosis. RRP Task Force. Arch. Otolaryngol. Head Neck Surg. 125(7), 743–748 (1999)CrossRefPubMed
9.
go back to reference Armstrong, L.R., et al.: Incidence and prevalence of recurrent respiratory papillomatosis among children in Atlanta and Seattle. Clin. Infect. Dis. 31(1), 107–109 (2000)CrossRefPubMed Armstrong, L.R., et al.: Incidence and prevalence of recurrent respiratory papillomatosis among children in Atlanta and Seattle. Clin. Infect. Dis. 31(1), 107–109 (2000)CrossRefPubMed
10.
go back to reference Hartwig, S., Baldauf, J.J., Dominiak-Felden, G.: Estimation of the epidemiological burden of HPV-related cancers, precancerous lesions, and genital warts in women and men in Europe: potential additional benefit of a nine-valent compared to first generation HPV vaccines. Papillomavirus Res 1, 90–100 (2015)CrossRefPubMedCentral Hartwig, S., Baldauf, J.J., Dominiak-Felden, G.: Estimation of the epidemiological burden of HPV-related cancers, precancerous lesions, and genital warts in women and men in Europe: potential additional benefit of a nine-valent compared to first generation HPV vaccines. Papillomavirus Res 1, 90–100 (2015)CrossRefPubMedCentral
13.
14.
go back to reference Favato, G., et al.: Novel health economic evaluation of a vaccination strategy to prevent HPV-related diseases: the BEST study. Med. Care 50(12), 1076–1085 (2012)CrossRefPubMed Favato, G., et al.: Novel health economic evaluation of a vaccination strategy to prevent HPV-related diseases: the BEST study. Med. Care 50(12), 1076–1085 (2012)CrossRefPubMed
17.
go back to reference Ferrandina, G., et al.: Hospital costs incurred by the Italian National Health Service for invasive cervical cancer. Gynecol. Oncol. 119(2), 243–249 (2010)CrossRefPubMed Ferrandina, G., et al.: Hospital costs incurred by the Italian National Health Service for invasive cervical cancer. Gynecol. Oncol. 119(2), 243–249 (2010)CrossRefPubMed
18.
go back to reference Mennini, F.S., et al.: Anti-HPV vaccination: a review of recent economic data for Italy. Vaccine 27(Suppl 1), A54–A61 (2009)CrossRefPubMed Mennini, F.S., et al.: Anti-HPV vaccination: a review of recent economic data for Italy. Vaccine 27(Suppl 1), A54–A61 (2009)CrossRefPubMed
19.
go back to reference Giorgi Rossi, P., et al.: Epidemiology and costs of cervical cancer screening and cervical dysplasia in Italy. BMC Public Health 9, 71 (2009)CrossRefPubMed Giorgi Rossi, P., et al.: Epidemiology and costs of cervical cancer screening and cervical dysplasia in Italy. BMC Public Health 9, 71 (2009)CrossRefPubMed
20.
go back to reference Mennini, F.S., et al.: Health and economic impact associated with a quadrivalent HPV vaccine in Italy. Gynecol. Oncol. 112(2), 370–376 (2009)CrossRefPubMed Mennini, F.S., et al.: Health and economic impact associated with a quadrivalent HPV vaccine in Italy. Gynecol. Oncol. 112(2), 370–376 (2009)CrossRefPubMed
21.
go back to reference Salute, M.: Remunerazione prestazioni di assistenza ospedaliera per acuti, assistenza ospedaliera di raibilitazione e di lungodegenza post acuzie e di assistenza specialistica ambulatoriale. 2013, Pubblicato sulla GURI N. 23 del 28/01/2013 Suppl. n. 8 Salute, M.: Remunerazione prestazioni di assistenza ospedaliera per acuti, assistenza ospedaliera di raibilitazione e di lungodegenza post acuzie e di assistenza specialistica ambulatoriale. 2013, Pubblicato sulla GURI N. 23 del 28/01/2013 Suppl. n. 8
22.
go back to reference Merito, M., et al.: Treatment patterns and associated costs for genital warts in Italy. Curr. Med. Res. Opin. 24(11), 3175–3183 (2008)CrossRefPubMed Merito, M., et al.: Treatment patterns and associated costs for genital warts in Italy. Curr. Med. Res. Opin. 24(11), 3175–3183 (2008)CrossRefPubMed
24.
go back to reference Mennini, F.S., et al.: Burden of disease of human papillomavirus (HPV): hospitalizations in the Marche and Veneto regions. An observational study. Clin. Drug Investig. 38(2), 173–180 (2018)CrossRefPubMed Mennini, F.S., et al.: Burden of disease of human papillomavirus (HPV): hospitalizations in the Marche and Veneto regions. An observational study. Clin. Drug Investig. 38(2), 173–180 (2018)CrossRefPubMed
25.
26.
go back to reference Fattore, G.: Proposta di linee guida per la valutazione economica degli interventi sanitari in Italia. PharmacoEcon. Ital. Res. Artic. 11(2), 83–93 (2009)CrossRef Fattore, G.: Proposta di linee guida per la valutazione economica degli interventi sanitari in Italia. PharmacoEcon. Ital. Res. Artic. 11(2), 83–93 (2009)CrossRef
27.
go back to reference Bishai, D., Kashima, H., Shah, K.: The cost of juvenile-onset recurrent respiratory papillomatosis. Arch. Otolaryngol. Head Neck Surg. 126(8), 935–939 (2000)CrossRefPubMed Bishai, D., Kashima, H., Shah, K.: The cost of juvenile-onset recurrent respiratory papillomatosis. Arch. Otolaryngol. Head Neck Surg. 126(8), 935–939 (2000)CrossRefPubMed
28.
go back to reference Hu, D., Goldie, S.: The economic burden of noncervical human papillomavirus disease in the United States. Am. J. Obstet. Gynecol. 198(5), 500e1–500e7 (2008)CrossRef Hu, D., Goldie, S.: The economic burden of noncervical human papillomavirus disease in the United States. Am. J. Obstet. Gynecol. 198(5), 500e1–500e7 (2008)CrossRef
30.
go back to reference AIOM, A.: I numeri del cancro in Italia 2017. I.P.S. Editore, Editor (2017) AIOM, A.: I numeri del cancro in Italia 2017. I.P.S. Editore, Editor (2017)
31.
go back to reference Serrano, B., et al.: Human papillomavirus genotype attribution for HPVs 6, 11, 16, 18, 31, 33, 45, 52 and 58 in female anogenital lesions. Eur. J. Cancer 51(13), 1732–1741 (2015)CrossRefPubMed Serrano, B., et al.: Human papillomavirus genotype attribution for HPVs 6, 11, 16, 18, 31, 33, 45, 52 and 58 in female anogenital lesions. Eur. J. Cancer 51(13), 1732–1741 (2015)CrossRefPubMed
32.
go back to reference WHO, I., Information Centre on HPV and Cervical Cancer (HPV Information Centre). Human papillomavirus and related cancers in Italy, I. Summary Report, Editor (2017) WHO, I., Information Centre on HPV and Cervical Cancer (HPV Information Centre). Human papillomavirus and related cancers in Italy, I. Summary Report, Editor (2017)
33.
go back to reference Garcia-Espinosa, B., Moro-Rodriguez, E., Alvarez-Fernandez, E.: Genotype distribution of human papillomavirus (HPV) in histological sections of cervical intraepithelial neoplasia and invasive cervical carcinoma in Madrid, Spain. BMC Cancer 12, 533 (2012)CrossRefPubMedPubMedCentral Garcia-Espinosa, B., Moro-Rodriguez, E., Alvarez-Fernandez, E.: Genotype distribution of human papillomavirus (HPV) in histological sections of cervical intraepithelial neoplasia and invasive cervical carcinoma in Madrid, Spain. BMC Cancer 12, 533 (2012)CrossRefPubMedPubMedCentral
34.
go back to reference Hartwig, S., et al.: Estimation of the epidemiological burden of human papillomavirus-related cancers and non-malignant diseases in men in Europe: a review. BMC Cancer 12, 30 (2012)CrossRefPubMedPubMedCentral Hartwig, S., et al.: Estimation of the epidemiological burden of human papillomavirus-related cancers and non-malignant diseases in men in Europe: a review. BMC Cancer 12, 30 (2012)CrossRefPubMedPubMedCentral
35.
36.
go back to reference Castellsague, X., et al.: HPV involvement in head and neck cancers: comprehensive assessment of biomarkers in 3680 patients. J. Natl. Cancer Inst. 108(6), djv403 (2016)CrossRefPubMed Castellsague, X., et al.: HPV involvement in head and neck cancers: comprehensive assessment of biomarkers in 3680 patients. J. Natl. Cancer Inst. 108(6), djv403 (2016)CrossRefPubMed
37.
go back to reference Miralles-Guri, C., et al.: HPV prevalence and type distribution in penile carcinoma. J. Clin. Pathol. 62(10), 870–878 (2009)CrossRefPubMed Miralles-Guri, C., et al.: HPV prevalence and type distribution in penile carcinoma. J. Clin. Pathol. 62(10), 870–878 (2009)CrossRefPubMed
38.
go back to reference Donne, A.J., et al.: The role of HPV type in Recurrent Respiratory Papillomatosis. Int. J. Pediatr. Otorhinolaryngol. 74(1), 7–14 (2010)CrossRefPubMed Donne, A.J., et al.: The role of HPV type in Recurrent Respiratory Papillomatosis. Int. J. Pediatr. Otorhinolaryngol. 74(1), 7–14 (2010)CrossRefPubMed
39.
go back to reference Fusconi, M., et al.: Recurrent respiratory papillomatosis by HPV: review of the literature and update on the use of cidofovir. Acta Otorhinolaryngol. Ital. 34(6), 375–381 (2014)PubMedPubMedCentral Fusconi, M., et al.: Recurrent respiratory papillomatosis by HPV: review of the literature and update on the use of cidofovir. Acta Otorhinolaryngol. Ital. 34(6), 375–381 (2014)PubMedPubMedCentral
40.
go back to reference Lacey, C.J., Lowndes, C.M., Shah, K.V.: Chap. 4: Burden and management of non-cancerous HPV-related conditions: HPV-6/11 disease. Vaccine 24(Suppl 3), S3/35–S41 (2006) Lacey, C.J., Lowndes, C.M., Shah, K.V.: Chap. 4: Burden and management of non-cancerous HPV-related conditions: HPV-6/11 disease. Vaccine 24(Suppl 3), S3/35–S41 (2006)
41.
go back to reference Briggs, A.H., Claxton, K., Sculpher, M.J.: Decision modelling for health economic evaluation. Handbooks in health economic evaluation series. Oxford University Press, Oxford (2006) (x, 237, ill.; 24 cm) Briggs, A.H., Claxton, K., Sculpher, M.J.: Decision modelling for health economic evaluation. Handbooks in health economic evaluation series. Oxford University Press, Oxford (2006) (x, 237, ill.; 24 cm)
42.
go back to reference Favato, G., Vecchiato, R.: Embedding real options in scenario planning: a new methodological approach. Technol. Forecast. Soc. Change 124(November 2017), 135–149 (2017)CrossRef Favato, G., Vecchiato, R.: Embedding real options in scenario planning: a new methodological approach. Technol. Forecast. Soc. Change 124(November 2017), 135–149 (2017)CrossRef
43.
go back to reference Brown, B., et al.: An economic evaluation of cetuximab combined with radiotherapy for patients with locally advanced head and neck cancer in Belgium, France, Italy, Switzerland, and the United Kingdom. Value Health 11(5), 791–799 (2008)CrossRefPubMed Brown, B., et al.: An economic evaluation of cetuximab combined with radiotherapy for patients with locally advanced head and neck cancer in Belgium, France, Italy, Switzerland, and the United Kingdom. Value Health 11(5), 791–799 (2008)CrossRefPubMed
44.
go back to reference Mandic, A., Usaj Knezevic, S., Kapicl, T., Ivkovic: Tissue expression of VEGF in cervical intraepithelial neoplasia and cervical cancer. J BUON 19(4), 958–964 (2014)PubMed Mandic, A., Usaj Knezevic, S., Kapicl, T., Ivkovic: Tissue expression of VEGF in cervical intraepithelial neoplasia and cervical cancer. J BUON 19(4), 958–964 (2014)PubMed
45.
go back to reference Friedlander, M., Grogan, M., Force, U.S.P.S.T.: Guidelines for the treatment of recurrent and metastatic cervical cancer. Oncologist 7(4), 342–347 (2002)PubMed Friedlander, M., Grogan, M., Force, U.S.P.S.T.: Guidelines for the treatment of recurrent and metastatic cervical cancer. Oncologist 7(4), 342–347 (2002)PubMed
46.
go back to reference Tewari, K.S., et al.: Bevacizumab for advanced cervical cancer: final overall survival and adverse event analysis of a randomised, controlled, open-label, phase 3 trial (Gynecologic Oncology Group 240). Lancet 390(10103), 1654–1663 (2017)CrossRefPubMedPubMedCentral Tewari, K.S., et al.: Bevacizumab for advanced cervical cancer: final overall survival and adverse event analysis of a randomised, controlled, open-label, phase 3 trial (Gynecologic Oncology Group 240). Lancet 390(10103), 1654–1663 (2017)CrossRefPubMedPubMedCentral
Metadata
Title
Economic burden of HPV9-related diseases: a real-world cost analysis from Italy
Authors
F. S. Mennini
Gianluca Fabiano
G. Favato
P. Sciattella
P. Bonanni
C. Pinto
A. Marcellusi
Publication date
01-08-2019
Publisher
Springer Berlin Heidelberg
Published in
The European Journal of Health Economics / Issue 6/2019
Print ISSN: 1618-7598
Electronic ISSN: 1618-7601
DOI
https://doi.org/10.1007/s10198-019-01044-3

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