Cost-effectiveness of HPV vaccination in Belize

Walwyn, Leslie; Janusz, Cara Bess; Clark, Andrew; Prieto, E.; Waight, Eufemia; Largaespada, Natalia

doi:10.1016/j.vaccine.2014.12.042

Cited by 13 publications

(10 citation statements)

References 5 publications

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“…Cost‐effectiveness analyses (CEA) consistently demonstrate that HPV vaccination is cost‐effective if the vaccine is purchased at a reduced rate . Although 2 of these studies were funded by the manufacturer of the bivalent vaccine, independent studies specific to Belize, Brazil, and Colombia also have found that HPV vaccination of girls was cost‐effective if procured at a reduced price . The CEA performed for Belize, Brazil, and Colombia considered various vaccination and screening scenarios, the incidence and mortality of CC, and each country's gross domestic product to determine the cost‐effectiveness threshold (determined to be 3 times the gross domestic product).…”

Section: Improving CC Control In Lamentioning

confidence: 99%

“…The CEA performed for Belize, Brazil, and Colombia considered various vaccination and screening scenarios, the incidence and mortality of CC, and each country's gross domestic product to determine the cost‐effectiveness threshold (determined to be 3 times the gross domestic product). The study from Belize modeled the outcomes of vaccinating a cohort of 4000 girls at age 10 years with the quadrivalent vaccine at a price of $13.79 per dose and found that the cost of vaccination per disability‐adjusted life‐year (DALY) averted was $429/DALY, which is well below the cost‐effectiveness threshold of $14,385/DALY for Belize . The Brazilian CEA found that the most cost‐effective strategy was to vaccinate adolescent girls if the vaccine costs <$100 per woman and simultaneously to perform CC screening 3 times over the course of a woman's lifetime .…”

Section: Improving CC Control In Lamentioning

confidence: 99%

“…[79][80][81][82] Although 2 of these studies were funded by the manufacturer of the bivalent vaccine, 80,83 independent studies specific to Belize, Brazil, and Colombia also have found that HPV vaccination of girls was cost-effective if procured at a reduced price. 81,82,84 The CEA performed for Belize, Brazil, and Colombia considered various vaccination and screening scenarios, the incidence and mortality of CC, and each country's gross domestic product to determine the costeffectiveness threshold (determined to be 3 times the gross domestic product). The study from Belize modeled the outcomes of vaccinating a cohort of 4000 girls at age 10 years with the quadrivalent vaccine at a price of $13.79 per dose and found that the cost of vaccination per disability-adjusted life-year (DALY) averted was $429/ DALY, which is well below the cost-effectiveness threshold of $14,385/DALY for Belize.…”

Section: Cost-effectivenessmentioning

confidence: 99%

“…The study from Belize modeled the outcomes of vaccinating a cohort of 4000 girls at age 10 years with the quadrivalent vaccine at a price of $13.79 per dose and found that the cost of vaccination per disability-adjusted life-year (DALY) averted was $429/ DALY, which is well below the cost-effectiveness threshold of $14,385/DALY for Belize. 82 The Brazilian CEA found that the most cost-effective strategy was to vaccinate adolescent girls if the vaccine costs <$100 per woman and simultaneously to perform CC screening 3 times over the course of a woman's lifetime. 84 For Colombia, vaccinating girls aged 12 years is cost-effective with a 3-dose schedule if the vaccines are purchased at $49 per dose for the quadrivalent vaccine and $47 per dose for the bivalent vaccine.…”

Section: Cost-effectivenessmentioning

confidence: 99%

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Cervical cancer control in Latin America: A call to action

Bychkovsky

Ferreyra²,

Strasser‐Weippl

et al. 2015

Cancer

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Cervical cancer (CC) is second most common cause of cancer in Latin America and is a leading cause of cancer mortality among women. In 2015, an estimated 74,488 women will be diagnosed with CC in Latin America and 31,303 will die of the disease. CC mortality is projected to increase by 45% by 2030 despite human papillomavirus (HPV) vaccination and screening efforts. In this setting, the goal was of the current study was to examine CC control efforts in Latin America and identify deficiencies in these efforts that could be addressed to reduce CC incidence and mortality. The authors found that HPV vaccination has been introduced in the majority of Latin American countries, and there is now a need to monitor the success (or shortcomings) of these programs and to ensure that these programs are sustainable. This topic was also reviewed in light of emerging data demonstrating that visual inspection with acetic acid and HPV DNA testing without Papanicolaou tests have efficacy from a screening perspective and are good alternatives to cytology-based screening programs. Overall, there is a need to build capacity for CC control in Latin America and the best strategy will depend on the country/region and must be tailored to meet the needs of the population as well as available resources. Cancer 2016;122:502-14.

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Section: Improving CC Control In Lamentioning

confidence: 99%

Section: Improving CC Control In Lamentioning

confidence: 99%

Section: Cost-effectivenessmentioning

confidence: 99%

Section: Cost-effectivenessmentioning

confidence: 99%

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Cervical cancer control in Latin America: A call to action

Bychkovsky

Ferreyra²,

Strasser‐Weippl

et al. 2015

Cancer

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“…7 There remain lots of debate around whether it is cost-effective to expand the existing vaccination programs to also include women older than 26 years, heterosexual men, and men who have sex with men (MSM). Unlike HPV vaccination for adolescent girls and women up to 26 years which has been shown to be highly cost-effective in many studies, [8][9][10][11][12][13] relatively fewer cost-effectiveness analyses (CEA) on HPV vaccination have been conducted in other population groups. This study aims to investigate the cost-effectiveness of HPV vaccination program for women older than 26 years, heterosexual men and MSM and the factors that drive its cost-effectiveness through a literature review.…”

Section: Introductionmentioning

confidence: 99%

Should human papillomavirus vaccination target women over age 26, heterosexual men and men who have sex with men? A targeted literature review of cost-effectiveness

Soe

Ong

et al. 2018

Human Vaccines & Immunotherapeutics

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Background: Human papillomavirus (HPV) vaccination for young women up to age 26 is highly costeffective and has been implemented in 65 countries globally. We investigate the cost-effectiveness for HPV vaccination program in older women (age > 26 years), heterosexual men and men who have sex with men (MSM). Method: A targeted literature review was conducted on PubMed for publications between January 2000 and January 2017 according to the PRISMA guidelines. We included English-language articles that reported the incremental cost-effectiveness ratio (ICER) of HPV vaccination programs for women over age 26, heterosexual men, and MSM and identified the underlying factors for its cost-effectiveness. Results: We included 36 relevant articles (six, 26 and four in older women, heterosexual men and MSM, respectively) from 17 countries (12 high-income (HICs) and five low-and middle-income (LMICs) countries). Most (4/6) studies in women over age 26 did not show cost-effectiveness ($65,000-192,000/QALY gained). Two showed cost-effectiveness, but only when the vaccine cost was largely subsidised and protection to non-naïve women was also considered. Sixteen of 26 studies in heterosexual men were cost-effective (ICER = $19,600-52,800/QALY gained in HICs; $49-5,860/QALY gained in LMICs). Nonavalent vaccines, a low vaccine price, fewer required doses, and a long vaccine protection period were key drivers for cost-effectiveness. In contrast, all four studies on MSM consistently reported cost-effectiveness (ICER = $15,000-$43,000/QALY gained), particularly in MSM age < 40 years and those who were HIV-positive. Countries' vaccination coverage did not significantly correlate with its per-capita Gross National Income. Conclusion: Targeted HPV vaccination for MSM should be next priority in HPV prevention after having established a solid girls vaccination programme. Vaccination for heterosexual men should be considered when 2-dose 4vHPV/9vHPV vaccines become available with a reduced price, whereas targeted vaccination for women over age 26 is unlikely to be cost-effective.

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