title: A Cost Analysis of the 1-2-3 Pap Intervention.
abstract: BACKGROUND
  Cervical cancer places a substantial economic burden on our healthcare system. The three-dose human papillomavirus (HPV) vaccine series is a cost-effective intervention to prevent HPV infection and resultant cervical cancer. Despite its efficacy, completion rates are low in young women aged 18 through 26 years. 1-2-3 Pap is a video intervention tested and proven to increase HPV vaccination completion rates.
  
  
  OBJECTIVE
  To provide the full scope of available evidence for 1-2-3 Pap, this study adds economic evidence to the intervention's efficacy. This study tested the economies of scale hypothesis that the cost of 1-2-3 Pap intervention per number of completed HPV vaccine series would decrease when offered to more women in the target population.
  
  
  METHODS
  Using cost and efficacy data from the Rural Cancer Prevention Center, a cost analysis was done through a hypothetical adaptation scenario in rural Kentucky.
  
  
  RESULTS
  Assuming the same success rate as in the efficacy study, the 1-2-3 Pap adaptation scenario would cover 1000 additional women aged 18 through 26 years (344 in efficacy study; 1346 in adaptation scenario), and almost three times as many completed series (130 in efficacy study; 412 in adaptation scenario) as in the original 1-2-3 Pap efficacy study.
  
  
  CONCLUSIONS
  Determination of the costs of implementing 1-2-3 Pap is vital for program expansion. This study provides practitioners and decision makers with objective measures for scalability.
authors.affiliation: Centers for Disease Control and Prevention, krabarison@cdc.gov.
authors.forename: Kristina M
authors.initials: KM
authors.lastname: Rabarison
authors.affiliation: Division of Diabetes Translation, Centers for Disease Control and Prevention, RuiLi@cdc.gov.
authors.forename: Rui
authors.initials: R
authors.lastname: Li
authors.affiliation: Division of Population Health, Centers for Disease Control and Prevention, aez2@cdc.gov.
authors.forename: Connie L
authors.initials: CL
authors.lastname: Bish
authors.affiliation: University of Kentucky, robin@kcr.uky.edu.
authors.forename: Robin C
authors.initials: RC
authors.lastname: Vanderpool
authors.affiliation: University of Kentucky, richard.crosby@uky.edu.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Crosby
authors.affiliation: Division of Population Health, Centers for Disease Control and Prevention, mrm8@cdc.gov.
authors.forename: Mehran S
authors.initials: MS
authors.lastname: Massoudi
keywords: HPV vaccine; cervical cancer; cost analysis; economic evaluation; prevention research center