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Cost‐effectiveness calculations of human papillomavirus vaccination in Punjab may be flawed
Author(s) -
Suman Vivian,
Puliyel Jacob M.
Publication year - 2018
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.31075
Subject(s) - medicine , vaccination , cervical cancer , per capita , human papillomavirus , cost effectiveness , population , demography , human papillomavirus vaccine , cancer , environmental health , immunology , gardasil , risk analysis (engineering) , sociology
Prinja et al looked at the cost-effectiveness of the human papillomavirus (HPV) vaccine for adolescent girls in Punjab, India. They assumed that the cost of vaccination would be US $14.1 per child. The report suggests a 90% probability that vaccination would be cost-effective in Punjab (at a willingness-to-pay threshold of 10,000 Indian rupees per quality-adjusted life-year gained, which is one-tenth of the gross domestic product per capita [65 Indian rupees 5 US $1]). This contrasts with the findings of Diaz et al, who examined health and the economic impact of HPV vaccination and found that as the cost per vaccinated girl exceeded US $3.30, vaccination alone would no longer be more efficient than screening alone. For their calculations, Prinja et al estimated that in the current scenario in Punjab, with no one vaccinated against HPV, 1140 cases of cervical cancer due to HPV16 and HPV-18 occur during the lifetime of a given year’s birth cohort. They suggested that vaccinating 70% of the population with a vaccine that is 93% effective would bring this down to 400 cases and result in the prevention of 740 cases of cervical cancer. “Ultimately,” they wrote, “it would lead to a reduction of 733 deaths due to cervical cancer.” They estimated that vaccinating girls would result in saving 18,477 life-years. There are a few problems with these estimates: