Journal of cancer policy · 2025
Economic evaluation of the one-dose HPV vaccination program in Nigeria.
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Gao Tianjiao, Farag Marwa, Agha Sohail, Mobula Linda, Hou Xiaohui, Li Guohong, Zeng Wu
Аннотация
BACKGROUND: This study retrospectively examines the cost-effectiveness of the national HPV vaccination program using the program cost and coverage data in Nigeria.
METHODS: We conducted a cost-effectiveness analysis of the HPV vaccination program compared with no vaccination in Nigeria, adopting both health system and societal perspectives. A static Markov model simulating HPV infection and cervical cancer outcomes was developed for a cohort of girls aged 9-14 years, followed until age 100. The model comprised primarily the following health states: susceptible, cervical cancer, and death. It further incorporated three additional pathways for patients with cervical cancer, including those with successful treatment, with treatment failure, and with no treatment.
RESULTS: The incremental cost-effectiveness ratio (ICER) was estimated at $268.67 per quality-adjusted life year (QALY) gained from the health system perspective and $217.85 per QALY gained from the societal perspective. Both ICERs were well below the cost-effectiveness threshold of one-time GDP per capita in Nigeria ($806.95). Key drivers of cost-effectiveness included vaccine cost, treatment success rate, cervical cancer treatment coverage, and cervical cancer utility values.
DISCUSSION: The single-dose HPV vaccination program is highly cost-effective in Nigeria, compared to the status quo of no vaccination. To ensure long-term sustainability, the Nigerian government should strengthen financing mechanisms and the healthcare system to support the program.
POLICY SUMMARY: Single dose HPV vaccination is cost-effective in Nigeria. It is crucial to obtain sustainable vaccine financing and improve treatment to maintain the program impact.
METHODS: We conducted a cost-effectiveness analysis of the HPV vaccination program compared with no vaccination in Nigeria, adopting both health system and societal perspectives. A static Markov model simulating HPV infection and cervical cancer outcomes was developed for a cohort of girls aged 9-14 years, followed until age 100. The model comprised primarily the following health states: susceptible, cervical cancer, and death. It further incorporated three additional pathways for patients with cervical cancer, including those with successful treatment, with treatment failure, and with no treatment.
RESULTS: The incremental cost-effectiveness ratio (ICER) was estimated at $268.67 per quality-adjusted life year (QALY) gained from the health system perspective and $217.85 per QALY gained from the societal perspective. Both ICERs were well below the cost-effectiveness threshold of one-time GDP per capita in Nigeria ($806.95). Key drivers of cost-effectiveness included vaccine cost, treatment success rate, cervical cancer treatment coverage, and cervical cancer utility values.
DISCUSSION: The single-dose HPV vaccination program is highly cost-effective in Nigeria, compared to the status quo of no vaccination. To ensure long-term sustainability, the Nigerian government should strengthen financing mechanisms and the healthcare system to support the program.
POLICY SUMMARY: Single dose HPV vaccination is cost-effective in Nigeria. It is crucial to obtain sustainable vaccine financing and improve treatment to maintain the program impact.