Exploring the cost-effectiveness of HPV vaccination in Vietnam: insights for evidence-based cervical cancer prevention policy.

Department of Health Policy and Management, Program in Health Decision Science, Harvard School of Public Health, 718 Huntington Avenue, Boston, MA 02115, USA.
Vaccine (Impact Factor: 3.49). 07/2008; 26(32):4015-24. DOI: 10.1016/j.vaccine.2008.05.038
Source: PubMed

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.

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