Abstract
BackgroundCervical cancer is currently the leading cause of cancer mortality among women in South Vietnam and the second leading cause of cancer mortality in North Vietnam. Human papillomavirus (HPV) vaccination has the potential to substantially decrease this burden. The World Health Organization (WHO) recommends that a cost-effectiveness analysis of HPV vaccination is conducted before nationwide introduction.MethodsThe Papillomavirus Rapid Interface for Modeling and Economics (PRIME) model was used to evaluate the cost-effectiveness of HPV vaccine introduction. A costing study based on expert panel discussions, interviews and hospital case note reviews was conducted to explore the cost of cervical cancer care.ResultsThe cost of cervical cancer treatment ranged from US$368 – 11400 depending on the type of hospital and treatment involved. Under Gavi-negotiated prices of US$4.55, HPV vaccination is likely to be very cost-effective with an incremental cost per disability-adjusted life year (DALY) averted in the range US$780 - 1120. However, under list prices for Cervarix and Gardasil in Vietnam, the incremental cost per DALY averted for HPV vaccination can exceed US$8000.ConclusionHPV vaccine introduction appears to be economically attractive only if Vietnam is able to procure the vaccine at Gavi prices. This highlights the importance of initiating a nationwide vaccination programme while such prices are still available.
Highlights
Cervical cancer is currently the leading cause of cancer mortality among women in South Vietnam and the second leading cause of cancer mortality in North Vietnam
Human papillomavirus (HPV) vaccine introduction appears to be economically attractive only if Vietnam is able to procure the vaccine at Gavi prices
Our analysis suggests that routine HPV vaccination of 11-year-old girls in Vietnam has an incremental cost
Summary
Cervical cancer is currently the leading cause of cancer mortality among women in South Vietnam and the second leading cause of cancer mortality in North Vietnam. Human papillomavirus (HPV) vaccination has the potential to substantially decrease this burden. Infection with human papillomavirus (HPV) is a cause of many diseases including cervical cancer. About 90 types of human papillomavirus have been found but two types (16 and 18) are responsible for 75% to 80% of cases of cervical cancer in Europe and North America [1], and more than 70% of cases in Asia [2]. Studies based on smaller samples from older registry-based studies have found that incidence ranged from 6.8 cases per 100,000 women in the north of Vietnam [13] to 26 cases per 100,000 women in the south of Vietnam [14]. Cervical cancer is the main cause of female cancer
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