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HIQA begins HTA of extending HPV vaccination to boys

HIQA’s research will establish the clinical and cost-effectiveness of providing HPV vaccination to boys.

HPV is the virus that causes cervical cancer in women. It is known that there are other cancers associated with this virus that affect both men and women, such as anal, genital and oropharyngeal cancer. HPV is associated with the development of penile cancer in men, as well as being the cause of genital warts in both men and women.

HIQA’s Director of Health Technology Assessment and Deputy Chief Executive Dr Máirín Ryan said: “HPV infection is the most commonly acquired sexually transmitted viral infection. In most cases it causes no symptoms and is cleared by the body’s immune system. However, persistent infection can lead to the development of cancer.”

Ireland has a nationally funded, school-based, girls-only HPV immunisation programme. This commenced in 2010 with the quadrivalent (Gardasil) vaccine which protects against four strains of the HPV virus (6, 11, 16 and 18).

Dr Ryan continued: “The HPV vaccine has been proven to be safe. Additionally, it is highly effective at preventing infection with the HPV types most commonly linked with cancer and genital warts in both men and women. This HTA will investigate the clinical and cost-effectiveness of expanding the HPV vaccination programme to include boys, thereby extending them the opportunity to benefit from the vaccine and increasing HPV immunity in the wider population.

”HIQA’s assessment will also consider the wider implications of any proposed change to the vaccination programme, such as the budget impact, use of resources, and the ethical and societal implications.”

HIQA is currently forming an expert advisory group comprising representatives from key stakeholder groups who will advise the HTA evaluation team during the course of this assessment.

The final results of the HTA are expected next year and will be submitted to the Minister for Health for consideration.

The Terms of Reference of the HTA are to describe the epidemiology of human papillomavirus infection (HPV) and HPV-related disease in Ireland; review the clinical effectiveness of HPV vaccines; review the safety of HPV vaccines ; review the international literature on the cost-effectiveness of extending HPV vaccination to include boys; perform an economic evaluation of the addition of boys to the current immunisation programme; examine the effect of HPV vaccine uptake rates among girls on the clinical and cost-effectiveness of the addition of boys to the programme; estimate the budget impact of any changes to the current immunisation programme; estimate the organisational and resource implications of any changes to the current vaccination programme; consider any wider ethical or societal implications that the addition of boys to the current immunisation programme would have for patients, the general public or the healthcare system; and based on this assessment, advise on the extension of the national HPV immunisation schedule to include boys.

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