Estimates of the Annual Direct Medical Costs of the Prevention and Treatment of Disease Associated with Human Papillomavirus (HPV) in the United States

Background: Estimates of the direct medical costs of preventing and treating disease associated with HPV can help to quantify the economic burden of HPV and to illustrate the potential benefits of HPV vaccination.

Objectives: To update the estimated annual direct medical costs of the prevention and treatment of HPV-associated disease in the US, for all HPV types.

Methods:  We included the costs of cervical cancer screening and the treatment costs of the following HPV-associated health outcomes: cervical cancer, other anogenital cancers (anal, vaginal, vulvar and penile), oropharyngeal cancer, genital warts, and recurrent respiratory papillomatosis (RRP).  We obtained updated incidence and cost estimates from the literature.

Results: The overall annual direct medical cost burden of preventing and treating HPV-associated disease is about $8.0 billion (2010 US dollars).  Most of this cost is for cervical cancer screening ($6.6 billion), of which $5.4 billion is for routine cervical cancer screening and $1.2 billion is for follow-up costs.  The direct medical costs of cancer are almost $1 billion annually, of which $0.4 billion is for cervical cancer and $0.3 billion is for oropharyngeal cancer.  Genital warts and RRP account for annual costs of $288 million and $171 million, respectively.

Conclusions: Though generally consistent with previous estimates, our estimated burden of $8.0 billion is about 20% higher than previous estimates because (1) screening costs have increased in recent years, primarily due to the increased use of liquid-based cytology, (2) we included outcomes attributable to all HPV types (not just 6,11,16, and 18), and (3) overall health care costs have increased over time.

Implications for Programs, Policy, and Research:  Despite limitations, this study provides a useful update of the annual cost of prevention and treatment of HPV-associated diseases.  This updated estimate underscores the substantial economic burden of HPV and highlights the potential for HPV vaccination to reduce this burden.