[Economic evaluation for the prevention of cervical cancer by vaccination--from perspective of health insurance society and industry].

ABSTRACT

OBJECTIVE: The aim of this study is to estimate the budget impact in a health insurance society and an industry of promoting decision-making for endowing grants for vaccination as prophylaxis against cervical cancer (CC) by the health insurance society for employees. METHODS: The target population was Japanese female employees aged 20 to 34 and partners and daughters of male employees working for an overseas IT industry. By using a prevalence-based model, the author estimated expected costs in non-vaccination and vaccination scenarios and evaluated the 10-year financial impact on the industry after vaccination by employing a cost-benefit analysis. The incidence of CC in a target group was derived from the actual number of patients with CC in addition to data from JMDC's receipt database and estimated by a Bayesian method. The epidemiological parameters such as mortality rate, screening rate, detailed exam rate and detailed exam consultation rate were taken from epidemiology statistics and published articles available in Japan. Healthcare costs for cancer treatment, screening, detailed exam and vaccination estimated based on medical fee points were input into the model, 'but the analysis did not consider side effect-related costs. In addition, productivity costs for mortality in employees and their families due to CC, estimated by the national employee's statistics, were also input into the model. An annual discount was unconsidered. RESULTS: From the perspective of the healthcare insurance society, expenditure of approximately 129 million yen in the non-vaccination scenario was expected for ten years, but healthcare-related costs were saved by expenditure of approximately 73 million yen with 100% of employees and their families being vaccinated at expenses of approximately 55 million yen. The insurance society lost approximately 1.8 million yen in total if subsidy for vaccination was set at ten thousand yen. In the case of a 100% vaccination rate, the company can save losses in productivity of approximately 563 million yen in ten years as compared with non-inoculation. Furthermore, family finance can save approximately 2.6 million yen, based on our analysis. Sensitivity analyses suggested that subsidy expenses, the uptake rate of vaccination, and time horizon influenced the mortality cost from the perspectives of the company and the employees' families. CONCLUSION: A grant for vaccinating women, who are an untargeted population for a public grant, by the health insurance society is meaningful for the prevention of CC. It was deemed that a grant for vaccination of women by the health insurance society would be approximately ten thousand yen.