Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jun 13.
doi: 10.1007/s15010-025-02567-z. Online ahead of print.

Cost-effectiveness analysis of HPV vaccination of men who have sex with men in Germany

Cody Palmer  1   2 , Cornelia Wähner  3 , Regine Wölle  4 , Alexander Kreuter  5 , Jens Peter Klussmann  6 , Julian Witte  7 , Agnes Luzak  4 , Miriam Reuschenbach  8
Affiliations

Cost-effectiveness analysis of HPV vaccination of men who have sex with men in Germany

Cody Palmer et al. Infection. .

Abstract

Introduction: Men who have sex with men (MSM) have a high risk of human papillomavirus (HPV) infection and HPV-related diseases. While gender neutral HPV vaccination between the ages of 9-14 years (with the option for catch-up between 15- and 17-years-of-age) has been recommended in Germany since 2018, adult MSM are currently not included and thus do not benefit from its advantages. This analysis aims to quantify the reduction in public health and health economic burden of including 18-26-year-old or 18-45-year-old MSM in the national HPV vaccination recommendation, compared to the status quo of vaccinating adolescent boys only.

Methods: We developed a dynamic transmission model of HPV, with an integrated HIV model, to analyze the potential impact of the 9-valent HPV vaccination on HPV infections and HPV-related diseases (anal, penile, and oropharyngeal cancers, and anogenital warts). By including economic outcomes, the model provides estimates of the cost-effectiveness of HPV vaccination among adult MSM in Germany.

Results: Vaccinating MSM aged 18-26 years could prevent an additional 2,583 anal, penile and oropharyngeal cancers, 709 deaths and 81,372 anogenital warts. Expanding vaccination to MSM aged 18-45 years, 4,091 cancers, 1,516 deaths and 114,117 anogenital warts could be averted. The highest reductions were found in anal cancers and anogenital warts; significant incidence reductions in cancers were seen within about 20 years. Vaccinating 18-26 and 18-45-year-old MSM resulted in Incremental Cost-Effectiveness Ratios (ICERs) of 35,300.09€/QALY and 42,088.06€/QALY, respectively, when compared to the vaccination of adolescent boys only.

Conclusions: Vaccination of MSM up to 26 and 45 years of age can profoundly accelerate beneficial public health outcomes while reducing the economic burden of HPV-related cancers and anogenital warts in a cost-effective way compared to vaccinating adolescent boys only.

Keywords: Disease burden; Dynamic transmission model; Economic burden; Human papillomavirus; Men who have sex with men; Vaccination.

PubMed Disclaimer

Conflict of interest statement

Declarations. Competing interests: Cornelia Wähner, Miriam Reuschenbach and Agnes Luzak are full-time employees of MSD Sharp & Dohme GmbH. Regine Wölle is a retired employee of MSD Sharp & Dohme GmbH. Cody Palmer is full-time employee of Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA. Jens Peter Klussmann received a research grant and honoraria as member of medical advisory boards from MSD Sharp & Dohme GmbH. Alexander Kreuter received honoraria as speaker and honoraria as member of medical advisory boards from MSD Sharp & Dohme GmbH. Julian Witte reports grants from MSD Sharp & Dohme GmbH during the conduct of the study; grants from Sanofi, GSK, Viatris, Seqirus, Pfizer, Janssen, and DAK-Gesundheit outside the submitted work.

Similar articles

See all similar articles

References

    1. Catalan Institute of Oncology (ICO); International Agency for Research on Cancer (IARC). HPV Information Centre. www.hpvcentre.net; 2023 [accessed 5 July 2023].
    1. Schiffman M, Castle PE, Jeronimo J, Rodriguez AC, Wacholder S. Human papillomavirus and cervical cancer. Lancet. 2007;370(9590):890–907. - DOI - PubMed
    1. AG HPV der Ständigen Impfkommission (STIKO). Wissenschaftliche Begründung für die Empfehlung der HPV-Diese Woche 26/2018 Impfung für Jungen im Alter von 9 bis 14 Jahren. In. Epid Bull 2018;26:233–250 2018.
    1. Taylor S, Bunge E, Bakker M, Castellsagué X. The incidence, clearance and persistence of non-cervical human papillomavirus infections: a systematic review of the literature. BMC Infect Dis. 2016;16(1):293. - DOI - PubMed - PMC
    1. Chin-Hong PV, Vittinghoff E, Cranston RD, Buchbinder S, Cohen D, Colfax G, Da Costa M, Darragh T, Hess E, Judson F. Age-specific prevalence of anal human papillomavirus infection in HIV-negative sexually active men who have sex with men: the EXPLORE study. J Infect Dis. 2004;190(12):2070–6. - DOI - PubMed

LinkOut - more resources