OBJECTIVES

This study evaluate the clinical (incidence and mortality), cost-effectiveness, and budget impact analysis of HPV vaccine in Indonesia

METHODS

A population-based Markov model was used to evaluate the cost and the clinical impact of HPV vaccination for 10 years old girls in Indonesia. We consider two doses of all three available HPV vaccines adjusted with the HPV infection profile with 95% vaccination coverage to estimate the national cervical cancer incidence and mortality. The Budget impact analysis explores three different scenarios covering (1) 2 district per year expansion, (2) 1 province per year expansion and (3) achieving the National Immunization Program in 2024.

RESULTS

Upon fully vaccinating almost 2.3 million 10-year-old girls, 34,723; 43,414; and 51,522 cervical cancer cases were prevented by Quadrivalent, Bivalent and Nonavalent vaccines. Furthermore, the highest (591 cases) and lowest (399 cases) mortality were prevented by Nonavalent and Quadrivalent vaccines, respectively. Most of the vaccines and vaccine prices were considerably cost effective and only Bivalent vaccine with the GAVI/UNICEF price will be considered a cost-saving strategy. In order to provide national coverage of HPV vaccination in Indonesia, the government has to provide an annual budget of about US$49 and US$22 using the government contract price and GAVI/UNICEF price, respectively.

CONCLUSIONS

cervical cancer prevention policy in Indonesia is an appreciably cost-effective strategy. The inclusion of HPV vaccination into the national immunization policy requires strong budgeting and political commitment from decision maker.