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. 2025 Dec;21(1):2516322.
doi: 10.1080/21645515.2025.2516322. Epub 2025 Jul 15.

Cost-effectiveness modeling for gender-neutral human papillomavirus vaccines: A systematic literature review

Marisa Felsher  1 , Marcie Fisher-Borne  1 , Tufail Malik  1 , Nita Santpurkar  2 , Stephan Martin  2 , Omer Zaidi  2 , Wei Wang  1 , Cody Palmer  1
Affiliations

Cost-effectiveness modeling for gender-neutral human papillomavirus vaccines: A systematic literature review

Marisa Felsher et al. Hum Vaccin Immunother. 2025 Dec.

Abstract

Gender-neutral vaccination (GNV) of human papillomavirus (HPV) may help reduce the transmission and incidence of HPV-related diseases. However, approximately 40 countries have implemented HPV GNV schedules. We systematically evaluated HPV GNV cost-effectiveness models from January 2008 to May 2024 using MEDLINE, Embase, and Cochrane to identify key drivers of cost-effectiveness results. Fifty-three publications were included, primarily from high-income countries. Vaccine coverage, price, protection duration, and discount rates impacted cost-effectiveness, with lower prices and protection against HPV-related diseases resulting in cost-effective results. Results in models that included adults (≥18 years) were mixed and dependent on price, inclusion of non-cervical HPV-related diseases, and age groups considered. We conclude that HPV GNV can be a cost-effective strategy for preventing HPV-related diseases. However, its cost-effectiveness is highly dependent on vaccine coverage, price, and inclusion of non-cervical HPV-related diseases in models. Further economic evaluations of HPV GNV in low- and middle-income countries are recommended.

Keywords: Human papillomavirus; cervical cancer; cost-effectiveness; economic evaluation; intervention; screening; vaccination.

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Conflict of interest statement

Marisa Felsher, Marcie Fisher-Borne, Tufail Malik, Wei Wang, and Cody Palmer are employees of Merck & Co., Inc. Nita Santpurkar, Stephan Martin, and Omer Zaidi are employees of OPEN Health, which received funding from Merck & Co., Inc. in connection with this publication(s).

Figures

*Duplicates, animal publication(s), language, time restriction, article unable to be retrieved.
Figure 1.
PRISMA flow diagram.
Abbreviations: CC, cervical cancer; HPV, human papillomavirus; MSM, men who have sex with men.
Figure 2.
Key drivers of gender-neutral vaccination cost-effectiveness.
See this image and copyright information in PMC

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References

    1. Chesson HW, Dunne EF, Hariri S, Markowitz LE.. The estimated lifetime probability of acquiring human papillomavirus in the United States. Sex Transm Dis. 2014;41(11):660. doi: 10.1097/OLQ.0000000000000193. - DOI - PMC - PubMed
    1. de Sanjosé S, Diaz M, Castellsagué X, Clifford G, Bruni L, Muñoz N, Bosch FX. Worldwide prevalence and genotype distribution of cervical human papillomavirus DNA in women with normal cytology: a meta-analysis. Lancet Infect. Dis. 2007;7(7):453–35. doi: 10.1016/S1473-3099(07)70158-5. - DOI - PubMed
    1. de Martel C, Plummer M, Vignat J, Franceschi S. Worldwide burden of cancer attributable to HPV by site, country and HPV type. Int J Cancer. 2017;141(4):664–670. doi: 10.1002/ijc.30716. - DOI - PMC - PubMed
    1. Pešut E, Đukić A, Lulić L, Skelin J, Šimić I, Milutin Gašperov N, Tomaić V, Sabol I, Grce M. Human papillomaviruses-associated cancers: an update of current knowledge. Viruses. 2021;13(11):2234. doi: 10.3390/v13112234. - DOI - PMC - PubMed
    1. World Health Organization . Immunization, vaccines and biologicals: human papillomavirus vaccines (HPV). [accessed 2024 Nov 23]. https://www.who.int/teams/immunization-vaccines-and-biologicals/diseases...).

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