Research
General gynecology
The economic burden of noncervical human papillomavirus disease in the United States

https://doi.org/10.1016/j.ajog.2008.03.064Get rights and content

Objective

The purpose of this study was (1) to estimate the direct medical costs of 7 major noncervical human papillomavirus (HPV)–related conditions that include genital cancers, mouth and oropharyngeal cancers, anogenital warts, and juvenile-onset recurrent respiratory papillomatosis, and (2) to approximate the economic burden of noncervical HPV disease.

Study Design

For each condition, we synthesized the best available secondary data to produce lifetime cost per case estimates, which were expressed in present value. Using an incidence-based approach, we then applied these costs to develop an aggregate measure of economic burden.

Results

The economic burden that was associated with noncervical HPV-6–, -11–, -16–, and -18–related conditions in the US population in the year 2003 approximates $418 million (range, $160 million to $1.6 billion).

Conclusion

The economic burden of noncervical HPV disease is substantial. Analyses that assess the value of investments in HPV prevention and control programs should take into account the costs and morbidity and mortality rates that are associated with these conditions.

Section snippets

Materials and Methods

We focused on 7 HPV-related conditions: HPV-6– and -11–associated anogenital warts, HPV-6– and -11–associated JORRP, and HPV-16– and -18–associated noncervical genital cancers (including anus, penis, vagina, vulva) and cancers of the mouth and oropharynx.

Juvenile-onset Recurrent Respiratory Papillomatosis

Cost estimates for juvenile-onset recurrent respiratory papillomatosis were obtained from a published study.9 In this study, the discounted lifetime cost per case was estimated at $131,910, with a wide plausible range of $54,800-$276,170. Base case assumptions included an average duration of illness of 4.2 years during which each patient underwent 4.4 surgical procedures per year, a ratio of follow-up office visits to surgery of 3:1, and a tracheotomy rate of 11%.9 Costs that were considered

Comment

Despite formidable data gaps, our review of secondary data and estimation of the direct medical costs that are associated with 7 HPV-related conditions demonstrate a substantial economic burden imposed by HPV-attributable noncervical disease in the United States. With the use of an incidence-based approach, the economic burden associated with noncervical HPV-related conditions that occurred in the United States in the year 2003 approximates $418 million. This figure has a considerably wide

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    This study was supported in part by grant 1406-04-07-CT-66327 from the Centers for Disease Control and Prevention and R01 CA093435 from the National Cancer Institute.

    Cite this article as: Hu D, Goldie S. The economic burden of noncervical human papillomavirus disease in the United States. Am J Obstet Gynecol 2008;198:500.e1-500.e7.

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