Cost-effectiveness of the introduction of two-dose bi valent (Cervarix) and quadrivalent (Gardasil) HPV vaccination for adolescent girls in Bangladesh

Mahumud, Rashidul Alam ORCID: and Gow, Jeff and Alam, Khorshed ORCID: and Keramat, Syed Afroz and Hossain, Md Golam and Sultana, Marufa and Sarker, Abdur Razzaque and Islam, Sheikh M. Shariful (2020) Cost-effectiveness of the introduction of two-dose bi valent (Cervarix) and quadrivalent (Gardasil) HPV vaccination for adolescent girls in Bangladesh. Vaccine, 38 (2). pp. 165-172. ISSN 0264-410X


Cervical cancer is one of the most prevalent cancers in women caused by the human papillomavirus (HPV) that leads to a substantial disease burden for health systems. Prevention through vaccination can significantly reduce the prevalence of cervical cancer. The objective of this study is to evaluate the potential health and economic impacts of introducing two-dose bivalent (Cervarix) and quadrivalent (Gardasil) HPV vaccines in Bangladesh.

Methods: The study uses the Papillomavirus Rapid Interface for Modelling and Economics (PRIME) model to assess the cost-effectiveness of introducing HPV vaccination. The incremental cost-effectiveness ratios (ICERs) were estimated per disability-adjusted life years (DALYs) averted using the cost-effectiveness threshold (CET). The analyses were done from a health system perspective in terms of vaccine delivery routes.

Results: Introduction of bi-valent HPV vaccination was found highly cost-effective (ICER = US$488/DALY) at Gavi (The Vaccine Alliance for Vaccines and Immunizations) negotiated prices. The value of ICERs were US$710, US$356 and US$397 per DALY averted for school-based, health facility-based, and outreachbased
programs, respectively, which is consistent with the CET range (US$67 to US$854). However, bivalent and quadrivalent vaccines at listed prices were not found cost-effective, with ICERs of US$1405 and US$3250 per DALY averted, respectively, that exceeds the CETs values.

Conclusions: Introducing a two-dose bi-valent HPV vaccination program is cost-effective in Bangladesh at Gavi negotiated prices. Vaccine price is the dominating parameter for the cost-effectiveness of bivalent and quadrivalent vaccines. Both vaccines are not cost effective at listed prices in Bangladesh. The evaluation highlights that introducing the two-dose bivalent HPV vaccine at Gavi negotiated prices into a national immunization program in Bangladesh is economically viable to reduce the burden of cervical cancer.

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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Additional Information: Files associated with this item cannot be displayed due to copyright restrictions.
Faculty/School / Institute/Centre: Historic - Institute for Resilient Regions - Centre for Health, Informatics and Economic Research (1 Aug 2018 - 31 Mar 2020)
Faculty/School / Institute/Centre: Historic - Faculty of Business, Education, Law and Arts - School of Commerce (1 Jul 2013 - 17 Jan 2021)
Date Deposited: 30 Jan 2020 00:12
Last Modified: 07 May 2020 22:56
Uncontrolled Keywords: Human papillomavirus; Bi-valent and quadrivalent vaccines; Cost-effectiveness analysis; Incremental cost-effectiveness ratios; Disability-adjusted life years; Bangladesh
Fields of Research (2008): 14 Economics > 1402 Applied Economics > 140208 Health Economics
Fields of Research (2020): 38 ECONOMICS > 3801 Applied economics > 380108 Health economics
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