Cost-Effectiveness Analysis of the Introduction of HPV Vaccination of 9-Year-Old-Girls in Iran

(2018) Cost-Effectiveness Analysis of the Introduction of HPV Vaccination of 9-Year-Old-Girls in Iran. Value Health Reg Issues. pp. 112-119. ISSN 2212-1102 (Electronic) 2212-1099 (Linking)

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Abstract

OBJECTIVES: To estimate the cost effectiveness of introducing the quadrivalent human papillomavirus (HPV) vaccine into the national immunization program of Iran. METHODS: The CERVIVAC cost-effectiveness model was used to calculate incremental cost per averted disability-adjusted life-year by vaccination compared with no vaccination from both governmental and societal perspectives. Calculations were based on epidemiologic parameters from the Iran National Cancer Registry and other national data sources as well as from literature review. We estimated all direct and indirect costs of cervical cancer treatment and vaccination program. All future costs and benefits were discounted at 3 per year and deterministic sensitivity analysis was used. RESULTS: During a 10-year period, HPV vaccination was estimated to avert 182 cervical cancer cases and 20 deaths at a total vaccination cost of US 23,459,897; total health service cost prevented because of HPV vaccination was estimated to be US 378,646 and US 691,741 from the governmental and societal perspective, respectively. Incremental cost per disability-adjusted life-year averted within 10 years was estimated to be US 15,205 and US 14,999 from the governmental and societal perspective, respectively, and both are higher than 3 times the gross domestic product per capita of Iran (US 14,289). Sensitivity analysis showed variation in vaccine price, and the number of doses has the greatest volatility on the incremental cost-effectiveness ratio. Using a two-dose vaccination program could be cost-effective from the societal perspective (incremental cost-effectiveness ratio = US 11,849). CONCLUSIONS: Introducing a three-dose HPV vaccination program is currently not cost-effective in Iran. Because vaccine supplies cost is the most important parameter in this evaluation, considering a two-dose schedule or reducing vaccine prices has an impact on final conclusions.

Item Type: Article
Keywords: Child *Cost-Benefit Analysis Female Health Expenditures Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18/*administration & dosage/economics Humans Immunization Programs *Models, Statistical Papillomavirus Infections/economics/epidemiology/prevention & control Quality-Adjusted Life Years Uterine Cervical Neoplasms/epidemiology/prevention & control *Vaccination CERVIVAC model DALYs HPV vaccine Iran cost effectiveness
Divisions: Faculty of Medicine > Departments of Clinical Sciences > Department of Social Medicine
Page Range: pp. 112-119
Journal or Publication Title: Value Health Reg Issues
Journal Index: Pubmed
Volume: 15
Identification Number: https://doi.org/10.1016/j.vhri.2018.03.001
ISSN: 2212-1102 (Electronic) 2212-1099 (Linking)
Depositing User: Zahra Otroj
URI: http://eprints.mui.ac.ir/id/eprint/8057

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