Cost–benefit analysis of a projected national human papilloma virus vaccination programme in Lebanon

Abstract

Background: The adoption of a population-based human papilloma virus (HPV) vaccination programme is debated in Lebanon on epidemiological, sociocultural, logistical and economic grounds. Aims: This cost-benefit analysis contributes to generating quantitative evidence necessary for a decision regarding costs through locally available data. Methods: The 2 sides of the cost-benefit analysis equation are: estimation of the cost of HPV vaccination campaigns targeting 11 year-old girls, using the cheapest vaccine in 2016 and estimation of the management cost for treatment of a yearly average case-load for cervical cancer. Results: A Cervarix® only campaign would cost US$ 5 407 790 to vaccinate 38 083 11-year-old girls. The estimated cost of managing a mean annual mixed case-load of 100 incident cervical cancer cases would cost US$ 1 591 336. The nearest break-even point may occur 5 years after this current analysis. Conclusion: This cost-benefit analysis using limited available data indicates that massive HPV vaccination would not be cost-beneficial under the circumstances existing in 2016. Nevertheless, some indications point to the need for a re-assessment around 2020. This finding will inform public health decision-makers in Lebanon and similar neighbouring countries.

Cervix Uteri Cancer in Lebanon: Incidence, Temporal Trends, and Comparison to Countries From Different Regions in the World

“… 45 A cost-benefit analysis using the limited available data in Lebanon indicated that massive HPV vaccination targeting 11-year-old girls and using the cheapest vaccine would not be cost-beneficial under the circumstances that were existing in 2016. 46 However, in view of the increasing risky sexual behaviors among the Lebanese population in the past decade 47 - 49 , a periodic re-assessment of the cost-benefit analysis of a national HPV immunization program is recommended. Globally, there are huge disparities in women HPV immunization, with high prevalence in high-income and upper-middle-income countries and low prevalence in low-income and middle-income countries that have the highest CUca incidence and mortality.…”

“…45 A cost-benefit analysis using the limited available data in Lebanon indicated that massive HPV vaccination targeting 11-year-old girls and using the cheapest vaccine would not be cost-beneficial under the circumstances that were existing in 2016. 46 However, in view of the increasing risky sexual behaviors among the Lebanese population in the past decade [47][48][49] , a periodic re-assessment of the cost-benefit analysis of a national HPV immunization program is recommended. Globally, there are huge disparities in women 17 5.8 Israeli non-Jews (2012) 22 5.3 Israeli Jews (2012) 22 5.2 Jordan (2012) 24 1.3 Kuwait-Kuwaiti (2012) 22 3.2 Bahrain (2008-2012) 23 4.1 Saudi Arabia-Saudi (2013) 25 1.5 Iran, Golestan (2008-2011) 23…”

General Oncology Care in Lebanon

“…In addition to breast cancer, colon cancer, and HBV, lung cancer screening is advocated in Lebanon using an annual low-dose CT scan of the chest but remains with very limited applicability. Women are encouraged to do cervical cancer by PAP smear screening through a national campaign for the prevention of cervical cancer [19].…”

“…The HPV prevention vaccine is supported for the prevention of cervical cancer. However, a populationbased vaccination program for cervical cancer is still not established [19].…”

Willingness to pay for and acceptance of cervical cancer prevention methods: A systematic review and meta-analysis

“…Even in many LMICs, cervical cancer is the most common cause of cancer deaths, with half a million new cases diagnosed worldwide each year, with nearly 250 000 deaths ( 4 ). Relatively effective methods are available today in the management of this cancer ( 5 ).…”