Introduction: Since 2007, the German Standing Vaccination Committee recommends HPV vaccination for girls aged 12-17 with a 2- (Cervarix®) or 4-valent (Gardasil®) vaccine. A 9-valent vaccine (Gardasil 9®) recently received a European market authorization in 2015.
Methods: A dynamic transmission model was calibrated to the German setting and used to estimate costs and QALYs associated with vaccination strategies.
Results: Compared to the current vaccination program, the 9-valent vaccine extended to boys shows further reductions of 24% in the incidence of cervical cancer, 30% and 14% in anal cancer for males and females, as well as over a million cases of genital warts avoided after 100 years. The new strategy is associated with an ICER of 22,987€ per QALY gained, decreasing to 329€ when considering the vaccine switch for girls-only.
Conclusion: Universal vaccination with the 9-valent vaccine can yield significant health benefits when compared to the current program.
Keywords: Cost-effectiveness; Germany; HPV; cervical cancer; vaccination.