title: The potential cost-effectiveness of adding a human papillomavirus vaccine to the cervical cancer screening programme in South Africa.
abstract: This study was designed to answer the question of whether a cervical cancer prevention programme that incorporates a human papillomavirus (HPV) vaccine is potentially more cost-effective than the current strategy of screening alone in South Africa. We developed a static Markov state transition model to describe the screening and management of cervical cancer within the South African context. The incremental cost-effectiveness ratio of adding HPV vaccination to the screening programme ranged from US $1078 to 1460 per quality-adjusted life year (QALY) gained and US$3320-4495 per life year saved, mainly depending on whether the study was viewed from a health service or a societal perspective. Using discounted costs and benefits, the threshold analysis indicated that a vaccine price reduction of 60% or more would make the vaccine plus screening strategy more cost-effective than the screening only approach. To address the issue of affordability and cost-effectiveness, the pharmaceutical companies need to make a commitment to price reductions.
authors.affiliation: Health Economics Unit, School of Public Health & Family Medicine, University of Cape Town, Anzio Road, Observatory 7925, Cape Town, South Africa. Edina.Sinanovic@uct.ac.za
authors.forename: Edina
authors.initials: E
authors.lastname: Sinanovic
authors.forename: Jennifer
authors.initials: J
authors.lastname: Moodley
authors.forename: Mark A
authors.initials: MA
authors.lastname: Barone
authors.forename: Sumaya
authors.initials: S
authors.lastname: Mall
authors.forename: Susan
authors.initials: S
authors.lastname: Cleary
authors.forename: Jane
authors.initials: J
authors.lastname: Harries
mesh_terms: D000293:Adolescent; D000328:Adult; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008390:Markov Chains; D008875:Middle Aged; D018803:Models, Economic; D030361:Papillomavirus Infections / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000191:economics*; D019057:Quality-Adjusted Life Years; D013019:South Africa / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines