No Italian data are currently available on the lifetime cost per patient affected by Respiratory Recurrent Papillomatosis (RRP). Our estimates were modelled on the basis of the few data published in the international literature (1). More specifically, the lifetime prevalence of tracheostomy in RRP patients was estimated in the range of 11-14%. The annual costs incurred by patients after tracheostomy were estimated to be $75,000 ± $15,000 per year over a 4.2 year time horizon.
In absence of Italian data, we chose a conservative approach to cost modelling. The lifetime prevalence of tracheostomy was set at 11% of the RRP patients, the lowest limit of the previously published range. Concerning the annualised costs, we estimated them to be equal to a single intervention of minor tracheostomic surgery or maintainance (DRG 75) per year over the 4.2 year time horizon. The annualised, inflation-adjusted cost of € 9,998 which was used to inform the model resulted significantly lower than the estimates published for the U.S.
The lack of local epidemiological and cost data represents one of the major limitations of our study, but it should not represent a major bias in the overall estimate of the economic burden of HPV-related diseases in Italy.

Prof. Giampiero Favato
Corresponding Author

Reference
1. Bishai D, Kashima H, Shah K (2000) The cost of juvenile-onset recurrent respiratory papillomatosis. Archives of Otolaryngology – Head and Neck Surgery 126: 935–939.