The Volokh Conspiracy - Cost-Effectiveness of HPV Immunizations:

Not everything that improves health, or even saves lives, is worth mandating or even strongly pressuring (even if your philosophy is social welfare maximization; I'll speak later about how those with a more libertarian bent might view this). Saving a few lives at the costs of billions of dollars may end up not being cost-effective, especially given that the expense could reduce people's ability to spend on much more cost-effective health improvements.

But my very rough back-of-the-envelope calculation suggests that the HPV vaccination is pretty cost-effective. The CDC reports that the retail price of the HPV vaccine is about $360; let's assume this ends up being roughly the cost, setting aside bulk discounts, extra labor costs for administering the vaccine and the like. About 2500 American women die of HPV each year, which means that the lifetime risk for a typical American woman is roughly 2500 x 75 / 150,000,000 = one in a thousand.

Given that most estimates of value of life saved I've seen run in the $5 million to $10 million range, avoiding a 1/1000 risk of premature death for $360 sounds pretty cost-effective. Of course a more full analysis would have to include many other factors: It should consider years of life lost rather than just deaths. It should consider the possibility that the people who die of cervical cancer are also the ones least likely to get the immunizations; cervical cancer can largely be avoided through regular pap smears, so it stands to reason that women who get it tend to be ones who are least likely to have good health insurance coverage, and they may be the ones who are most likely not to get immunized when they are girls. It should also consider, as a factor countervailing to this one, the possibility that herd immunity provided by very broad immunization will benefit even those who aren't immunized. And it should doubtless consider a bunch of other things, too.

Still, given that $360,000 is way under $5 to $10 million, it seems safe to say that include all the other factors will still yield a judgment that the HPV immunization is likely cost-effective.

	[Eugene Volokh, February 5, 2007 at 5:38pm] Trackbacks Cost-Effectiveness of HPV Immunizations: Not everything that improves health, or even saves lives, is worth mandating or even strongly pressuring (even if your philosophy is social welfare maximization; I'll speak later about how those with a more libertarian bent might view this). Saving a few lives at the costs of billions of dollars may end up not being cost-effective, especially given that the expense could reduce people's ability to spend on much more cost-effective health improvements. But my very rough back-of-the-envelope calculation suggests that the HPV vaccination is pretty cost-effective. The CDC reports that the retail price of the HPV vaccine is about $360; let's assume this ends up being roughly the cost, setting aside bulk discounts, extra labor costs for administering the vaccine and the like. About 2500 American women die of HPV each year, which means that the lifetime risk for a typical American woman is roughly 2500 x 75 / 150,000,000 = one in a thousand. Given that most estimates of value of life saved I've seen run in the $5 million to $10 million range, avoiding a 1/1000 risk of premature death for $360 sounds pretty cost-effective. Of course a more full analysis would have to include many other factors: It should consider years of life lost rather than just deaths. It should consider the possibility that the people who die of cervical cancer are also the ones least likely to get the immunizations; cervical cancer can largely be avoided through regular pap smears, so it stands to reason that women who get it tend to be ones who are least likely to have good health insurance coverage, and they may be the ones who are most likely not to get immunized when they are girls. It should also consider, as a factor countervailing to this one, the possibility that herd immunity provided by very broad immunization will benefit even those who aren't immunized. And it should doubtless consider a bunch of other things, too. Still, given that $360,000 is way under $5 to $10 million, it seems safe to say that include all the other factors will still yield a judgment that the HPV immunization is likely cost-effective. Related Posts (on one page): Transmission of Genital HPV Through the Hands: "100% Preventable by Behavioral Change": Libertarianism and Communicable Disease: HPV Immunization and Risky Personal Choices: Perverse Effects of HPV Immunizations? Cost-Effectiveness of HPV Immunizations: HPV Immunization in Texas: