Presentation (CTI)

OBJECTIVES: In Egypt, HPV vaccination is offered to female adolescents and adults aged ≥12 years. HPV vaccination has demonstrated clinical and economic benefits globally against cervical cancer and squamous intraepithelial lesions (SIL) of the cervix. This analysis evaluated the cost-effectiveness of HPV vaccinations among girls and women in Egypt.
METHODS: A static decision-tree model was adapted to the geographic setting in Africa to estimate costs and health outcomes associated with using HPV compared to not being vaccinated. The model simulated the HPV vaccination over a lifetime horizon from a public payer perspective. The vaccination coverage was assumed to be 80%. Other parameters were derived from published literature. Costs were converted to USD, 2025. Costs and benefits were discounted at 3% annually. Outcomes from deterministic base case analysis include total costs, total QALYs (quality adjusted life years), incremental costs, incremental QALYs and ICER (Incremental cost effectiveness ratio). Scenario analysis and sensitivity analysis will be conducted to test the robustness of the results against uncertainty.
RESULTS: Vaccinating females aged ≥12 years with HPV vaccine results in total costs of $1.03 billion and 23.9 million QALYs compared to no vaccination which results in health care costs of $60.5 million and 18.9 million QALYs. HPV vaccination led to increased costs by $971.9 million while generating 5.0 million additional QALYs, resulting in an ICER of $194.52 per QALY gained. The ICER is below the cost-effectiveness willingness-to- pay (WTP) threshold for Egypt which is one to three times the GDP per capita (approximately US $3,400-$3,500 per year). Therefore, HPV vaccination for females ≥12 years is highly cost effective from an Egyptian context.
CONCLUSIONS: With an assumed coverage of 80%, vaccinating females aged ≥12 years in Egypt is a highly cost-effective strategy with ICERs below the commonly accepted WTP threshold.