Publication: The economic evaluation of human papillomavirus vaccination strategies against cervical cancer in women in Lao PDR: a mathematical modelling approach
Issued Date
2016
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Language
eng
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Mahidol University
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BioMed Central
Bibliographic Citation
BMC Health Services Research. Vol. 16, (2016), 418
Suggested Citation
Phetsavanh Chanthavilay, Reinharz, Daniel, Mayfong Mayxay, Keokedthong Phongsavan, Marsden, Donald E., Moore, Lynne, White, Lisa J. The economic evaluation of human papillomavirus vaccination strategies against cervical cancer in women in Lao PDR: a mathematical modelling approach. BMC Health Services Research. Vol. 16, (2016), 418. doi:10.1186/s12913-016-1662-5 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/2747
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Title
The economic evaluation of human papillomavirus vaccination strategies against cervical cancer in women in Lao PDR: a mathematical modelling approach
Abstract
Background: Cervical cancer, a preventable disease, is the third leading cause of cancer morbidity and mortality in
the Lao People’s Democratic Republic (Lao PDR). Since many cervical cancers are linked to human papilloma virus
(HPV) infection, vaccination against this virus may lead to a reduction in these types of cancer. The study described
here is the first to compare the cost-effectiveness of different HPV vaccination options in Lao PDR.
Methods: A dynamic compartment model was created. The model included routine screening activities already in
place, as well as theoretical interventions that included a 10-year old girl-only vaccination programme combined
with/without a 10-year old boy vaccination programme and/or a catch-up component. The simulation was run
over 100 years. In base case analyses, we assumed 70 % vaccination coverage with lifelong protection and 100 %
efficacy against HPV types 16/18. The outcomes of interest were the incremental cost per Disability-Adjusted Life
Year (DALY) averted.
Results: In base case analyses, according to the WHO definition of cost-effectiveness thresholds, vaccinating
10-year-old girls was very cost-effective. Adding a catch-up vaccination element for females aged 11–25 years
was also very cost-effective, costing 1559 international dollars (I$) per DALY averted. Increasing the age limit of
the catch-up vaccination component to 75 years old showed that this remained a cost-effective option (I$ 5840 per
DALY averted). Adding a vaccination programme for 10-year-old boys was not found to be cost-effective unless a short
time simulation (30 years or less) was considered, along with a catch-up vaccination component for both males
and females.
Conclusions: Adding a catch-up female vaccination component is more attractive than adding a 10-year-old boy
vaccination component.