Abstract
Objectives
Many reviews have been conducted on the economic evaluation of the HPV vaccine in global north countries. But there is a dearth of such reviews in the Global South countries. Hence, this systematic review aims to summarize studies done in these countries.
Methods
Four databases PubMed, Embase, Cochrane Library, and Google Scholar from 2009 to 2019 were searched for economic evaluations on HPV vaccination in the Global South countries. PRISMA guidelines were followed to include full-text articles. 40 original articles were shortlisted for full-text review.
Results
Studies had varied models, assumptions, and results according to different scenarios. Most studies concluded HPV vaccination to be cost-effective under varied scenarios and vaccine cost was the most influential parameter affecting the sensitivity analyses, consequently incremental cost-effectiveness ratio. A wide range in the cost-effectiveness ratio was observed in the included studies due to different study settings, populations, and inconsistencies in modeling practices (variations in methodological approaches).
Conclusions
This review suggests the introduction of HPV vaccination alone or in combination with screening according to different countries. The price of the vaccine should be economical and funds for the vaccine should be provided by public sector firms.
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References
Aguilar M, Otilia L, García O et al (2015) Cost-effectiveness analysis of the introduction of the human papillomavirus vaccine in Honduras. Vaccine 33:A167–A173. https://doi.org/10.1016/j.vaccine.2014.12.067
Aljunid S, Maimaiti N, Nur AM et al (2016) Cost-effectiveness of HPV vaccination regime: comparing twice versus thrice vaccinations dose regime among adolescent girls in Malaysia. BMC Public Health. https://doi.org/10.1186/s12889-016-2754-1
Aponte-González J, Fajardo-bernal L, Diaz J, Eslava-schmalbach J (2013) Cost-effectiveness analysis of the bivalent and quadrivalent human papillomavirus vaccines from a societal perspective in Colombia. PLoS ONE 8:1–14. https://doi.org/10.1371/journal.pone.0080639
Bardach AE, Garay OU, Calderón M et al (2017) Health economic evaluation of human papillomavirus vaccines in women from Venezuela by a lifetime Markov cohort model. BMC Public Health. https://doi.org/10.1186/s12889-017-4064-7
Ben Hadj Yahia MB, Jouin-Bortolotti A, Dervaux B (2015) Extending the human papillomavirus vaccination programme to include males in high-income countries: a systematic review of the cost-effectiveness studies. Clin Drug Investig 35:471–485. https://doi.org/10.1007/s40261-015-0308-4
Brisson M, Van De Velde N, Boily MC (2009) Economic evaluation of human papillomavirus vaccination in developed countries. Public Health Genom 12:343–351. https://doi.org/10.1159/000214924
Burd E (2003) Human papillomavirus and cervical cancer. Clin Microbiol Rev 16: 1–17. http://www.sciencedirect.com/science/article/pii/S0140673607614160. https://doi.org/10.1128/CMR.16.1.1
Burger EA, Campos NG, Sy S et al (2018) Health and economic benefits of single-dose HPV vaccination in a Gavi-eligible country. Vaccine. https://doi.org/10.1016/j.vaccine.2018.04.061
Campos NG, Kim JJ, Castle PE et al (2012) Cervical cancer screening in Eastern Africa. Int J Cancer 2684:2672–2684. https://doi.org/10.1002/ijc.26269
Chanthavilay P, Reinharz D, Mayxay M et al (2016a) Economic evaluation of screening strategies combined with HPV vaccination of preadolescent girls for the prevention of cervical cancer in Vientiane. Lao PDR BMC Health Serv Res. https://doi.org/10.1371/journal.pone.0162915
Chanthavilay P, Reinharz D, Mayxay M et al (2016b) The economic evaluation of human papillomavirus vaccination strategies against cervical cancer in women in Lao PDR: a mathematical modeling approach. BMC Health Serv Res. https://doi.org/10.1186/s12913-016-1662-5
D’Addario M, Redmond S, Scott P et al (2017) Two-dose schedules for human papillomavirus vaccine: systematic review and meta-analysis. Vaccine 35:2892–2901. https://doi.org/10.1016/j.vaccine.2017.03.096
Drummond M et al (1997) Methods for the economic evaluation of health care programs, 2nd edn. Oxford University Press, Oxford
Ekwunife OI, Lhachimi SK (2017) Cost-effectiveness of human papilloma virus (HPV) vaccination in Nigeria: a decision analysis using pragmatic parameter estimates for cost and program coverage. BMC Health Serv Res. https://doi.org/10.1186/s12913-017-2758-2
Ezat SWP, Aljunid S (2010a) Comparative cost-effectiveness of HPV vaccines in the prevention of cervical cancer in Malaysia. Asian Pac J Cancer Prev 11:943–951
Ezat SWP, Aljunid S (2010b) Cost-effectiveness of HPV vaccination in the prevention of cervical cancer in Malaysia. Asian Pacific J Cancer Prev 11:79–90
Fesenfeld M, Hutubessy R, Jit M (2013) Cost-effectiveness of human papillomavirus vaccination in low and middle income countries: a systematic review. Vaccine 31:3786–3804. https://doi.org/10.1016/j.vaccine.2013.06.060
Fonseca AJD, Ferreira LCDL, Neto GB (2013) Cost-effectiveness of the vaccine against human papillomavirus in the Brazilian Amazon region. Rev Assoc Med Bras 59:442–451. https://doi.org/10.1016/j.ramb.2013.03.004
Germar MJ, Purugganan C, Bernardino MS, Cuenca B (2017) Cost-effectiveness analysis of AS04-adjuvanted human papillomavirus 16/18 vaccine compared with human papillomavirus 6/11/16/18 vaccine in the Philippines, with the new 2-dose schedule. Hum Vaccin Immunother. https://doi.org/10.1080/21645515.2016.1269991
Gervais F, Dunton K, Jiang Y, Largeron N (2017) Systematic review of cost-effectiveness analyses for combinations of prevention strategies against human papillomavirus (HPV) infection: a general trend. BMC Public Health 17:1–18. https://doi.org/10.1186/s12889-017-4076-3
Gomez JA, Lepetic A, Demarteau N (2014) Health economic analysis of human papillomavirus vaccines in women of Chile: perspective of the health care payer using a Markov model. BMC Public Health 14:1–13. https://doi.org/10.1186/1471-2458-14-1222
Guerrero AM, Genuino AJ, Santillan M et al (2015) A cost-utility analysis of cervical cancer screening and human papillomavirus vaccination in the Philippines. BMC Public Health 15:1–17. https://doi.org/10.1186/s12889-015-2046-1
Haider S, Chaikledkaew U, Thavorncharoensap M et al (2019) Systematic review and meta-analysis of cost-effectiveness of rotavirus vaccine in low-income and lower-middle-income countries. Open Forum Infect Dis. https://doi.org/10.1093/ofid/ofz117
International Monetary Fund Implied PPP conversion rate, https://www.imf.org/external/datamapper/PPPEX@WEO/OEMDC/ADVEC/WEOWORLD/HND. Accessed 27 Jan 2020
Kawai K, Tannus G, De Araujo B et al (2012) Estimated health and economic impact of in Brazil using a transmission dynamic model. BMC Infect Dis. https://doi.org/10.1186/1471-2334-12-250
Khatibi M, Reza H, Shahverdi Z, Reza H (2014) Cost-effectiveness evaluation of quadrivalent human papilloma virus vaccine for HPV-related disease in Iran. Iran J Pharm Res. 13:225–234
Kiatpongsan S, Kim JJ (2014) Costs and cost-effectiveness of 9-valent human papillomavirus (HPV) vaccination in two East African countries. PLoS ONE 9:1–6. https://doi.org/10.1371/journal.pone.0106836
Kim JJ, Brisson M, Edmunds WJ, Goldie SJ (2008) Modeling cervical cancer prevention in developed countries. Vaccine 26:76–86. https://doi.org/10.1016/j.vaccine.2008.06.009
Kim JJ, Campos NG, Shea MO et al (2013a) Model-based impact and cost-effectiveness of cervical cancer prevention in Sub-Saharan Africa. Vaccine 31:F60–F72. https://doi.org/10.1016/j.vaccine.2012.07.093
Kim JJ, Sharma M, Shea MO et al (2013b) Model-based impact and cost-effectiveness of cervical cancer prevention in the extended middle East and North Africa (EMENA). Vaccine 31:G65–G77. https://doi.org/10.1016/j.vaccine.2012.06.096
Kosen S, Andrijono A, Ocviyanti D (2017) The cost-effectiveness of quadrivalent human papillomavirus vaccination in Indonesia. Asian Pacific J Cancer Prev. https://doi.org/10.22034/APJCP.2017.18.7.2011
Kostaras D, Karampli E, Athanasakis K (2019) Vaccination against HPV virus: a systematic review of economic evaluation studies for developed countries. Taylor & Francis 19:147–158. https://doi.org/10.1080/14737167.2019.1555039
Kriekinge GV, Sohn W, Aljunid SM et al (2018) Comparative cost-effectiveness analysis of two different two-dose human papillomavirus vaccines in Malaysia. Asian Pac J Cancer Prev 19:933–940. https://doi.org/10.22034/APJCP.2018.19.4.933
Laprise JF, Drolet M, Boily MC et al (2014) Comparing the cost-effectiveness of two- and three-dose schedules of human papillomavirus vaccination: a transmission-dynamic modelling study. Vaccine 32:5845–5853. https://doi.org/10.1016/j.vaccine.2014.07.099
Levin CE, Sharma M, Olson Z et al (2015) Vaccination to prevent cervical cancer in China. Vaccine. https://doi.org/10.1016/j.vaccine.2015.02.052
Li X, Stander MP, Van Kriekinge G, Demarteau N (2015) Cost-effectiveness analysis of human papillomavirus vaccination in South Africa accounting for human immunodeficiency virus prevalence. BMC Infect Dis. https://doi.org/10.1186/s12879-015-1295-z
Liu Y, Zhang Q, Hu S, Zhao F (2016) Effect of vaccination age on cost-effectiveness of human papillomavirus vaccination against cervical cancer in China. BMC Cancer. https://doi.org/10.1186/s12885-016-2207-3
Marseille E, Larson B, Kazi DS et al (2015) Thresholds for the cost–effectiveness of interventions: alternative approaches. Bull World Health Organ 93:118–124. https://doi.org/10.2471/BLT.14.138206
Messoudi W, Elmahi T, Nejjari C et al (2019) Cervical cancer prevention in Morocco: a model- based cost-effectiveness analysis. J Med Econ. https://doi.org/10.1080/13696998.2019.1624556
Mo X, Tobe RG, Wang L et al (2017) Cost-effectiveness analysis of different types of human papillomavirus vaccination combined with a cervical cancer screening program in mainland China. BMC Infect Dis. https://doi.org/10.1186/s12879-017-2592-5
Novaes HMD, Coelho P et al (2015) Cost-effectiveness analysis of introducing universal human papillomavirus vaccination of girls aged 11 years into the National Immunization Program in Brazil. Vaccine 33:A135–A142. https://doi.org/10.1016/j.vaccine.2014.12.031
Praditsitthikorn N, Teerawattananon Y, Tantivess S et al (2011) Economic evaluation of policy options for prevention and control of cervical cancer in Thailand. Pharmacoeconomics 29:781–806. https://doi.org/10.2165/11586560-000000000-00000
Prinja S, Bahuguna P, Faujdar DS, Jyani G (2017) Cost-effectiveness of human papillomavirus vaccination for adolescent girls in Punjab state: implications for India’ s universal immunization program. Cancer. https://doi.org/10.1002/cncr.30734
Reynales-shigematsu LM, Rodrigues ER, Lazcano-ponce E (2009) Cost-effectiveness analysis of a quadrivalent human papilloma virus vaccine in Mexico. Arch Med Res 40:503–513. https://doi.org/10.1016/j.arcmed.2009.08.004
Setiawan D, Dolk FC, Suwantika AA et al (2016) Cost-utility analysis of human papillomavirus vaccination and cervical screening on cervical cancer patient in Indonesia. Value Heal Reg Issues 9:84–92. https://doi.org/10.1016/j.vhri.2015.10.010
Sharma M, Ortendahl J, Van Der Ham E, Sy S (2011) Cost-effectiveness of human papillomavirus vaccination and cervical cancer screening in Thailand. An Int J Obstet Gynaecol. https://doi.org/10.1111/j.1471-0528.2011.02974.x
Silas OA, Achenbach CJ, Murphy RL et al (2018) Cost effectiveness of human papilloma virus vaccination in low and middle income countries: a systematic review of literature. Expert Rev Vaccines 17:91–98. https://doi.org/10.1080/14760584.2018.1411195
Sinanovic E, Moodley J, Barone MA et al (2009) The potential cost-effectiveness of adding a human papillomavirus vaccine to the cervical cancer screening programme in South Africa. Vaccine. https://doi.org/10.1016/j.vaccine.2009.08.004
Sinisgalli E, Bellini I, Indiani L et al (2015) HPV vaccination for boys? A systematic review of economic studies. Epidemiol Prev 39:51–58
Termrungruanglert W, Havanond P, Khemapech N, Lertmaharit S (2012) Cost and effectiveness evaluation of prophylactic HPV vaccine in. Value Health 15:S29–S34. https://doi.org/10.1016/j.jval.2011.11.007
The World Bank. GDP per capita (current US$). https://data.worldbank.org/indicator/NY.GDP.PCAP.CD. 27 Jan 2020
The World Bank GDP per capita (current US$). https://data.worldbank.org/indicator/NY.GDP.PCAP.CD. Accessed 27 Jan 2020
Tracy JK, Schluterman NH, Greene C et al (2014) Planning for human papillomavirus (HPV) vaccination in sub-Saharan Africa: a modeling-based approach. Vaccine 32:3316–3322. https://doi.org/10.1016/j.vaccine.2014.03.067
UNDP (2004) Forging a global south. https://www.undp.org/content/dam/china/docs/Publications/UNDP-CH-PR-Publications-UNDay-for-South-South-Cooperation.pdf. Accessed 3 Oct 2019
United States Department of Labor Bureau of Labor Statistics. Consumer price index, http://www.bls.gov/cpi/. Accessed 27 Jan 2020
Van Minh H, Thi N, My T, Jit M (2017) Cervical cancer treatment costs and cost-effectiveness analysis of human papillomavirus vaccination in Vietnam: a PRIME modeling study. BMC Health Serv Res 17:1–7. https://doi.org/10.1186/s12913-017-2297-x
Vu M, Yu J, Awolude OA, Chuang L (2018) Cervical cancer worldwide. Curr Probl Cancer 42:457–465. https://doi.org/10.1016/j.currproblcancer.2018.06.003
Walwyn L, Bess C, David A, Prieto E (2015) Cost-effectiveness of HPV vaccination in Belize. Vaccine 33:A174–A181. https://doi.org/10.1016/j.vaccine.2014.12.042
World Health Organization Immunization, Vaccines and biologicals. https://www.who.int/immunization/diseases/hpv/en/. Accessed 5 Jan 2020
Yaghoubi M, Nojomi M, Vaezi A et al (2018) Cost-effectiveness analysis of the introduction of HPV vaccination of 9-year-old-girls in Iran. Value Heal Reg Issues 15:112–119. https://doi.org/10.1016/j.vhri.2018.03.001
Zhang Q, Liu Y, Hu S, Zhao F (2016) Estimating long-term clinical effectiveness and cost-effectiveness of HPV 16/18 vaccine in China. BMC Cancer. https://doi.org/10.1186/s12885-016-2893-x
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Abidi, S., Labani, S., Singh, A. et al. Economic evaluation of human papillomavirus vaccination in the Global South: a systematic review. Int J Public Health 65, 1097–1111 (2020). https://doi.org/10.1007/s00038-020-01431-1
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DOI: https://doi.org/10.1007/s00038-020-01431-1