Cost-benefit analysis on the HPV vaccine in Medicaid-enrolled females of the Appalachian region of Kentucky.

OBJECTIVE The objective of this study was to determine the cost-efficiency of vaccinating against Human Papillomavirus (HPV) in Medicaid enrolled females of the Appalachian region of Kentucky (n = 49,411 females) aged 12 to 25 years, versus paying for the treatment of cervical cancer cases (n = 643 cases) within this population later in life. METHODS In order to determine the cost of vaccination and cervical cancer treatment, the use of data acquired from the Kentucky Department of Medicaid Services (DMS) and Kentucky Cancer Registry (KCR) was necessary. RESULTS Relative Risk of Appalachian Kentuckian females developing cervical cancer compared to their non-Appalachian counterparts is 1.23. The total cost DMS paid to treat cervical cancer in 2005 in Appalachian counties was $5.95 million. The direct cost DMS paid in 2005 to treat cervical cancer was $960,910.95. The direct cost for the vaccine for the 2005 Medicaid-enrolled population aged 12 to 25 in Appalachian Kentucky counties is $17.8 million (price of $360 for the three-dose vaccine). The cost to vaccinate the subsequent 12-year-old cohort (n = 4,137 females, born in 1995) in the next year is $1.5 million. Each year similar additional costs would accrue. CONCLUSIONS Implementing a prevention plan for cervical cancer that includes annually vaccinating Medicaid-enrolled adolescent females of the Appalachian region of Kentucky against HPV infection is cost-efficient for the Medicaid system when considering the total expenditures associated with the illness. Recognition of an actual cost savings would not occur for several decades as the vaccinated population ages.