10th World Congress on Health Economics, Health Policy and Healthcare Management
London, UK
Esperança Lourenço Guimarães
Instituto Nacional de Saúde, Mozambique
Title: Cost-effectiveness of human papillomavirus vaccines for preadolescent girls in mozambique: A static cohort model
Biography
Biography: Esperança Lourenço Guimarães
Abstract
Statement of the problem: Mozambique has one of the highest rates of cervical cancer in the world. Human papillomavirus vaccination was introduced for pre-adolescent girls in November 2021. This study evaluated the health and economic impact of the current HPV vaccine (GARDASIL-4) and two other vaccines (CECOLIN and CERVARIX) that could be used in the future.
Methodology & theoretical orientation: A proportionate outcomes static cohort model was used to estimate the lifetime costs and benefits of vaccination with CECOLIN, CERVARIX and GARDASIL-4 in 10 cohorts of girls aged 9 years (2022-2031) and 5 cohorts of girls aged 10-14 years in the year 2022. The primary outcome measure was the incremental cost per Disability-Adjusted Life-Year (DALY) averted from a government perspective. Each vaccine was compared to no vaccination and to each other. We assessed uncertainty through deterministic and probabilistic sensitivity analyses.
Findings: Without cross-protection all three vaccines had similar health benefits (48% reduction in cervical cancer cases and deaths). With cross-protection CERVARIX could have substantially more health benefits than the other two products (62% versus 48% reduction). Without Gavi donor support, discounted vaccine program costs were $43 m for CECOLIN, $61 m for GARDASIL-4 and $69 m for CERVARIX. With Gavi donor support all vaccines had similar discounted vaccine program costs (US $27 million). In scenarios without cross-protection CECOLIN was dominant; CECOLIN was cost saving with Gavi support and still very cost-effective without Gavi support. In scenarios with cross-protection and Gavi support CERVARIX was dominant and cost-saving. With cross-protection and no Gavi support, CECOLIN had the most favorable cost-effectiveness.