MSD (Lithuania)

Background Human papillomavirus (HPV) is associated with a range of cancers that pose a considerable public health burden, considerable medical costs, and productivity losses. This study aims to assess the societal and fiscal gains from increasing vaccine coverage rates (VCRs) to 90% by 2030 for both sexes and all eligible age groups (higher VCR scenario) compared to present coverage rates in Switzerland. Methods A previously published dynamic transmission model was used to project gains from higher VCRs of the nonavalent vaccine compared to current coverage trends on vaccine-preventable HPV-related mortality, morbidity, and direct costs. Prevented deaths and morbidity, from cancers and genital warts were converted into averted loss of productive output and tax revenue, avoided disability and healthcare costs savings. Using evidence from the literature on the impact of HPV-related diseases on absenteeism, employment and disability rates, the averted economic burden was estimated and was compared with vaccination costs to assess the benefit-cost ratio (BCR) of higher VCRs. Economic effects were discounted at 3%, and the analytic time horizon was 100 years. Results Compared to current coverage rates, the higher VCR scenario results in healthcare cost savings of CHF834 million. Moreover, higher VCR scenarios likely generate societal gains of CHF218 million and CHF181 million from averted deaths and prevented morbidity, respectively. Averted absenteeism is expected to increase productive output by CHF147 million. Fiscally, the higher VCR scenario generates CHF100 million in tax revenue and CHF85 million in averted disability costs. Considering the incremental costs of vaccination, the resulting societal and fiscal BCRs are 1.5 and 1.2, respectively. Conclusion Attaining the 90% VCR targets by 2030 is projected to generate favorable economic returns for the Swiss government. Specifically, over the lifetime of the vaccinated cohorts, a CHF1 investment is estimated to yield societal and fiscal returns of CHF1.5 and 1.2, respectively.

ABSTRACT Background A bivalent human papillomavirus vaccine (2vHPV) is currently used in the Netherlands; a nonavalent vaccine (9vHPV) is also licensed. Research design and methods We compared the public health and economic benefits of 2vHPV- and 9vHPV-based vaccination strategies in the Netherlands over 100 years using a validated deterministic dynamic transmission metapopulation model. Results Compared to 2vHPV, the 9vHPV strategy averted an additional 3,245 cases of and 825 deaths from 9vHPV-strain-attributable cancers, 4,247 cases of and 190 deaths from recurrent respiratory papillomatosis (RRP), and 1,009,637 cases of anogenital warts (AGWs), with an incremental cost-effectiveness ratio (ICER) of €4,975 per quality-adjusted life year (QALY) gained. The ICER increased in a scenario with increased HPV vaccination coverage rates and was relatively robust to one-way deterministic sensitivity analyses, with variation in the disease utility parameter having the most impact. When catch-up vaccination for individuals ≤26 years of age was added to the model, vaccinating with 9vHPV averted additional cancers and AGWs compared to 2vHPV vaccination. Conclusion Our analyses predict that transitioning from a 2vHPV- to a 9vHPV-based vaccination strategy would be cost-effective in the Netherlands.

The aim of the present research is to make a contrastive analysis of that-deletion in complement that-clauses in English and Lithuanian on the basis of corpus data. All the data for analysis are collected from the British National Corpus and the Corpus of the Contemporary Lithuanian Language. That-deletion in complement that-clauses is studied in terms of distribution across registers, the properties of the matrix verbs and the structural properties of the clauses.