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ORIGINAL RESEARCH article
Front. Public Health
Sec. Health Economics
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1584956
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Background: In the context of oropharyngeal cancer poised to impose a significant disease burden, this study conducted an economic evaluation of HPV vaccination in Chinese male adolescents for the prevention of HPV-positive oropharyngeal cancer (OPC-HPV+), by constructing a multi-state Markov model from the societal perspective.The model estimated the cost, effectiveness, and health utility of the bivalent, quadrivalent, and nonavalent HPV vaccines in preventing OPC-HPV+. Incremental cost-utility ratio (ICUR) was used to evaluate the economic viability of the vaccination strategies. One-way sensitivity analysis and probabilistic sensitivity analysis were employed to assess the model's stability.Results: At a vaccine coverage rate of 70%, the incremental cost-effectiveness ratios of the bivalent, quadrivalent, and nonavalent vaccines were all lower than the per capita GDP compared to no vaccination, indicating that the vaccination strategies are highly cost-effective. The nonavalent vaccine has the highest incremental cost-effectiveness ratio, at 64,913.42 yuan ($9,211.86)/QALY. This strategy also has the highest cost, at 112.34 billion yuan, but it provides the best protection outcomes, preventing 2,545,988 cases of persistent HPV infection, 31,186 cases of OPC-HPV+, and 15,138 deaths, saving a total of 2,641,783 QALYs. Sensitivity analysis indicates that the discount rate, vaccine efficacy, HPV infection rate in the general population, and the probability of spontaneous clearance are the main factors affecting the pairwise comparison results of the strategies, which may lead to instability in the cost-effectiveness of the nonavalent vaccine.HPV vaccination for male adolescents to prevent oropharyngeal cancer is cost-effective compared to no vaccination. China could expand the coverage of the appropriate-priced HPV vaccine to male adolescents in order to reduce the incidence of oropharyngeal cancer, improve male health quality, and protect public health.
Keywords: HPV vaccine, Male Adolescents, oropharyngeal cancer, cost-effectiveness analysis, Markov model
Received: 28 Feb 2025; Accepted: 07 Apr 2025.
Copyright: © 2025 Li, Li, Qin, Wang, Wang and Zhou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Ruifeng Li, School of Management, Beijing University of Chinese Medicine, Beijing, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
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