COST-EFFECTIVENESS OF SINGLE-DOSE HPV VACCINATION IN NEPAL:AN ECONOMIC EVALUATION
Author(s)
Sanjeev K. Sahani, MPH1, Mehran Heydari Seradj, MS GHPM1, Deepak K. Jha, MPPM2, Donald S. Shepard, MPP, PhD, FASTMH1.
1Global Health Policy and Management, Brandeis University, Waltham, MA, USA, 2Department of Health Services, Kathmandu, Nepal.
1Global Health Policy and Management, Brandeis University, Waltham, MA, USA, 2Department of Health Services, Kathmandu, Nepal.
OBJECTIVES: Cervical cancer remains a leading cause of cancer morbidity and mortality among women in Nepal, driven by gaps in prevention and late stage diagnosis within a resource constrained health system. In 2025, Nepal implemented a nationwide single-dose human papillomavirus (HPV) vaccination campaign using Cecolin, achieving 93.7% coverage among 1.56 million girls aged 9-14 years. This study evaluated the cost effectiveness of the 2025 single-dose HPV vaccination campaign compared with a status quo without HPV vaccination.
METHODS: A cost-effectiveness analysis was conducted from a health system perspective using a lifetime horizon. The analysis compared no vaccination with the 2025 single-dose HPV vaccination campaign. Age-standardized cervical cancer incidence and mortality were obtained from GLOBOCAN and the Global Burden of Disease study. Treatment costs were sourced from Nepal, and health utility weights were derived from Indian EQ-5D-5L norms. Vaccine efficacy (87.5%) was based on a Phase III Cecolin® trial. Program costs included vaccine procurement, operational expenditures, and economic costs. Discounted costs and quality-adjusted life years (QALYs) were estimated, and incremental cost-effectiveness ratios (ICERs) per QALY gained were calculated.
RESULTS: In the absence of HPV vaccination, cervical cancer was projected to result in an annual loss of 176.13 QALYs per 100,000 females. At 93.7% coverage and 87.5% vaccine efficacy, single-dose HPV vaccination resulted in an incremental gain of 144.41 QALYs per 100,000 females per year, at a total program cost of USD 4,356,102 (USD 2.99 per vaccinated girl). Compared with the status quo, the intervention achieved greater health benefits at lower costs, yielding an ICER of −USD 50.83 per QALY gained and remaining well below Nepal’s historically-based cost-effectiveness threshold of USD 489.65 per QALY.
CONCLUSIONS: Single-dose HPV vaccination campaign delivers substantial health gains and strong economic value in Nepal, supporting its integration into the national immunization schedule and sustained domestic financing.
METHODS: A cost-effectiveness analysis was conducted from a health system perspective using a lifetime horizon. The analysis compared no vaccination with the 2025 single-dose HPV vaccination campaign. Age-standardized cervical cancer incidence and mortality were obtained from GLOBOCAN and the Global Burden of Disease study. Treatment costs were sourced from Nepal, and health utility weights were derived from Indian EQ-5D-5L norms. Vaccine efficacy (87.5%) was based on a Phase III Cecolin® trial. Program costs included vaccine procurement, operational expenditures, and economic costs. Discounted costs and quality-adjusted life years (QALYs) were estimated, and incremental cost-effectiveness ratios (ICERs) per QALY gained were calculated.
RESULTS: In the absence of HPV vaccination, cervical cancer was projected to result in an annual loss of 176.13 QALYs per 100,000 females. At 93.7% coverage and 87.5% vaccine efficacy, single-dose HPV vaccination resulted in an incremental gain of 144.41 QALYs per 100,000 females per year, at a total program cost of USD 4,356,102 (USD 2.99 per vaccinated girl). Compared with the status quo, the intervention achieved greater health benefits at lower costs, yielding an ICER of −USD 50.83 per QALY gained and remaining well below Nepal’s historically-based cost-effectiveness threshold of USD 489.65 per QALY.
CONCLUSIONS: Single-dose HPV vaccination campaign delivers substantial health gains and strong economic value in Nepal, supporting its integration into the national immunization schedule and sustained domestic financing.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE390
Topic
Economic Evaluation
Disease
SDC: Reproductive & Sexual Health, STA: Vaccines