Cost effectiveness of human papilloma virus vaccination in low and middle income countries: a systematic review of literature

Abstract

Low and middle income countries (LMICs) bear more than 50% of the current cervical cancer burden over the last decade with linkages to lack of HPV vaccination, high levels of poverty, illiteracy and nonexistent or poor screening programs. Governments of LMICs need enough convincing evidence that HPV vaccination will be more cost-effective in reducing the scourge of cervical cancer. Area covered: A systematic review to identify suitable studies from MEDLINE(via PubMed), EMBASE and Electronic search through GOOGLE for original and review articles from 2007 to 2014 on cost-effectiveness of human papilloma virus vaccination of pre-adolescent girls in LMICs was conducted. A total of 19 full articles were finally selected and reviewed after screening out those not consistent with the inclusion and exclusion criteria. Expert commentary: Most studies on cost-effectiveness of HPV vaccine in LMICs show that lowering cost of HPV vaccination with or without Pap smear screening is cost-effective in areas with high incidence of cervical cancer.

Cost-effectiveness of 2-dose human papillomavirus vaccination for 12-year-old girls in Zhejiang Province: implications for China’s expanded program on immunization

“…Our finding that 2-dose vaccination with this novel 2vHPV is very cost effective and has implications for CC control in both China and other resource-limited countries. Despite the heterogeneity of vaccination strategies and HPV prevalence, numerous studies 31,32 have shown that introducing HPV vaccines is cost effective. Especially in some resource-limited countries such as South Africa, Malaysia and India, introducing 2vHPV vaccines without screening is cost effective because of the high rates of CC in those countries.…”

Vaccination Against Cervical Cancer in India: Our Children Deserve a Healthier Future

“…A recent meta-analysis reported that the HPV vaccine program was economical in resource-constrained settings. 24 There was a media outcry in 2012 after a few deaths were reported in a cervical cancer trial that was conducted in India. 2,25,26 This led to an adverse public opinion in India against the HPV vaccine.…”

The odds that working women will accept cervical cancer screening and HPV vaccination

“…Health economics: The need for cost-effectiveness in public health services can never be overlooked, especially by the policy makers. 20 It may interest to note that there could economic returns from HPV vaccination. A systematic review study from Hong Kong reported HPV vaccination was considered to be cost-effective or costsaving, 21 though another systematic review highlighted that variations in the service strategies have implications on cost-effectiveness.…”

“…3 Even at the public health policy making level, the concept of belief is captured in the suggestion that "Governments need convincing evidence that HPV vaccination will be more cost-effective in reducing the scourge of cervical cancer". 20 Therefore, 'belief' is still an issue to address even in the public health ministry.…”