Tuesday, March 18, 2008

Determinants of parent and adolescent preferences and willingness to pay for HPV vaccination

Derek S. Brown, Public Health Economics Program, HSER, RTI International, 3040 Cornwallis Rd, Box 12194, Research Triangle Park, NC, USA, F. Reed Johnson, RTI Health Solutions, RTI International, 3040 Cornwallis Rd, Box 12194, Research Triangle Park, NC, USA, and Christine Poulos, HSER, RTI International, 3040 Cornwallis Rd, PO Box 12194, Research Triangle Park, NC, USA.

Learning Objectives for this Presentation:
By the end of the presentation, participants will be able to:
1. Describe key determinants of parent and adolescent preferences about HPV vaccination,
2. Identify discordance in preferences and expected uptake,
3. Discuss how preferences determine perceived value.
4. Use these results to tailor vaccine information to adolescents and parents.

A quadrivalent HPV vaccine was recommended by ACIP for females ages 9-26. The vaccine is effective, cost-effective, and safe but public perceptions are mixed. A bivalent HPV vaccine is currently under FDA review; if approved, this may complicate individual decisions about HPV vaccination. More information about the preferences for HPV vaccines may inform public health strategies.

We estimate the full economic “utility” value of vaccination for cost-benefit analysis. We survey mothers and daughters separately and estimate a joint decision-making model. Understanding both preferences is important for effective policy, since vaccination is recommended by ACIP for girls 11-12.

A conjoint analysis (discrete choice experiment) survey was fielded to a nationally representative internet sample of 350 U.S. mothers and daughters (age 13-17). Mothers and daughters completed separate instruments. Vaccine attributes were price, duration, and effectiveness against cervical cancer and genital warts.

Mothers and daughters both report significant, positive willingness to pay (WTP) values for HPV vaccination, but this is driven by different features among each. Mothers had a higher WTP and placed greater value on genital wart protection. Age was a significant predictor of girls' acceptability.

Differences between parent and child preferences indicate that information campaigns should be tailored by age group and emphasize different features to maximize coverage of HPV vaccination. We predict that a bivalent vaccine with lesser protection against genital warts will be less valued. High WTP for preventing cervical cancer makes HPV vaccination suggests that full cost-benefit calculations based on these results may be favorable.