title: Exploring the cost-effectiveness of HPV vaccination in Vietnam: insights for evidence-based cervical cancer prevention policy.
abstract: Using mathematical models of cervical cancer for the northern and southern regions of Vietnam, we assessed the cost-effectiveness of cervical cancer prevention strategies and the tradeoffs between a national and region-based policy in Vietnam. With 70% vaccination and screening coverage, lifetime risk of cancer was reduced by 20.4-76.1% with vaccination of pre-adolescent girls and/or screening of older women. Only when the cost per vaccinated girl was low (i.e., <I$25) was vaccination combined with screening (three times per lifetime or every 5 years) favored in both regions; at high costs per vaccinated girl (i.e., >I$100), screening alone was most cost-effective. When optimal policies differed between regions, implementing a national strategy resulted in health and economic inefficiencies. HPV vaccination appears to be an attractive cervical cancer prevention strategy for Vietnam, provided high coverage can be achieved in young pre-adolescent girls, cost per vaccinated girl is <I$25 (i.e., <$5 per dose), and screening is offered at older ages.
authors.affiliation: Department of Health Policy and Management, Program in Health Decision Science, Harvard School of Public Health, 718 Huntington Avenue, Boston, MA 02115, USA. jkim@hsph.harvard.edu
authors.forename: Jane J
authors.initials: JJ
authors.lastname: Kim
authors.forename: Katie E
authors.initials: KE
authors.lastname: Kobus
authors.forename: Mireia
authors.initials: M
authors.lastname: Diaz
authors.forename: Meredith
authors.initials: M
authors.lastname: O'Shea
authors.forename: Hoang
authors.initials: H
authors.lastname: Van Minh
authors.forename: Sue J
authors.initials: SJ
authors.lastname: Goldie
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003362:Cost-Benefit Analysis; D055317:Evidence-Based Practice; D005260:Female; D006291:Health Policy / Q000191:economics*; D006801:Humans; D018803:Models, Economic; D030361:Papillomavirus Infections / Q000453:epidemiology / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000191:economics*; D011159:Population Surveillance; D002583:Uterine Cervical Neoplasms / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control*; D014611:Vaccination / Q000191:economics*; D014744:Vietnam / Q000453:epidemiology
chemical_list: D053918:Papillomavirus Vaccines