| dc.description.abstract | Human papillomavirus (HPV) is a known carcinogen for cancer of the cervix, vagina, vulva, penis, anus and oropharynx, and accounts for approximately 5% of all cancer cases globally. The inclusion of the HPV vaccine in the Norwegian vaccination program can potentially reduce the number of HPV-related cancer cases and the burden of disease. In this context, it is important to identify the cancer-attributable costs as they may reflect future cost savings. More generally, cost estimates may be used for cost-effectiveness analysis of other disease-related interventions. However, there are no registry-based studies comprehensively estimating the current total economic burden of HPV-related cancers in Norway. The main objective of our analysis was to quantify the annual direct medical costs of the six HPV-related cancers in Norway from 2012-2014, with respect to specialist care, primary physician care and prescription drugs. We estimated the cost of HPV-related cancers, from a healthcare perspective, based on data sets from The Norwegian Patient Register, The Norwegian Control and Distribution of Health Reimbursement Database and The Norwegian Prescription Database. Furthermore, we assigned one cancer diagnosis to each patient based on ICD-10 codes and ICPC-2 codes, exploring the impact of five alternative diagnosis assignment methods. Lastly, we performed a prevalence analysis using average costing for diagnostic related costs in somatic hospitals, reimbursements of primary physician and private specialist care, pharmacy retail price for prescription drugs and patient copayments. The direct healthcare costs of all HPV-related cancers increased from 2012 to 2014. In 2014, treatment for cervical cancer had the largest total health care costs (NOK 145 806 623), while oropharyngeal cancer, anal cancer, vulvar cancer, penile cancer and vaginal cancer had lower costs (NOK 98 084 183, NOK 42 813 243, NOK 28 374 021, NOK 13 566 141, NOK 3 867 502, respectively). In 2014, the total direct medical costs of HPV-related cancers was NOK 332 511 713. The cost associated with specialist care accounted for more than 99% of the total direct medical costs, whereas primary physician care and prescription drugs together, accounted for less than 1% of the total cost. Although this study is limited by some uncertainties with respect to diagnosis as well as costs, the results indicate that HPV-related cancers, and in particular cervical cancer, represent a considerable burden to the Norwegian healthcare system. | eng |