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Showing content from https://pubmed.ncbi.nlm.nih.gov/33082132/ below:

Assessing the value of human papillomavirus vaccination in Gavi-eligible low-income and middle-income countries

. 2020 Oct;5(10):e003006. doi: 10.1136/bmjgh-2020-003006. Assessing the value of human papillomavirus vaccination in Gavi-eligible low-income and middle-income countries

Affiliations

¹ Centre for Health Economics, University of York, York, United Kingdom jessica.ochalek@york.ac.uk.
² Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.
³ Centre for Health Economics, University of York, York, United Kingdom.
⁴ Modelling and Economics Unit, Public Health England, London, United Kingdom.
⁵ School of Public Health, University of Hong Kong, Hong Kong Special Administrative Region, China.

PMID: 33082132
PMCID: PMC7577028
DOI: 10.1136/bmjgh-2020-003006

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Assessing the value of human papillomavirus vaccination in Gavi-eligible low-income and middle-income countries

Jessica Ochalek et al. BMJ Glob Health. 2020 Oct.

. 2020 Oct;5(10):e003006. doi: 10.1136/bmjgh-2020-003006. Affiliations

¹ Centre for Health Economics, University of York, York, United Kingdom jessica.ochalek@york.ac.uk.
² Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.
³ Centre for Health Economics, University of York, York, United Kingdom.
⁴ Modelling and Economics Unit, Public Health England, London, United Kingdom.
⁵ School of Public Health, University of Hong Kong, Hong Kong Special Administrative Region, China.

PMID: 33082132
PMCID: PMC7577028
DOI: 10.1136/bmjgh-2020-003006

Item in Clipboard

Abstract

Introduction: Estimating the value of providing effective healthcare interventions in a country requires an assessment of whether the improvement in health outcomes they offer exceeds the improvement in health that would have been possible if the resources required had, instead, been made available for other healthcare activities in that country. This potential alternative use of the same resources represents the health opportunity cost of providing the intervention. Without such assessments, there is a danger that blanket recommendations made by international organisations will lead to the adoption of healthcare interventions that are not cost effective in some countries, even given existing donor mechanisms intended to support their affordability.

Methods: We assessed the net health impact to 46 Gavi-eligible countries of achieving one of the WHO's proposed 90-70-90 targets for cervical cancer elimination, which includes 90% coverage of human papillomavirus (HPV) vaccination among girls by 15 years of age, using published estimates of the expected additional benefits and costs in each country and estimates of the marginal productivity of each healthcare system. We calculated the maximum price each country could afford to pay for HPV vaccination to be cost effective by assessing the net health impact that would be expected to be generated at different potential prices.

Results: At Gavi negotiated prices, HPV vaccination offers net health benefits across most Gavi-eligible countries included in this study. However, if Gavi-eligible countries faced the average price faced by non-Gavi eligible countries, providing HPV vaccination would result in reduced overall population health in most countries.

Conclusion: Estimates of the net health impact of providing a healthcare intervention can be used to assess the benefit (or lack of) to countries of adhering to global guidance, inform negotiations with donors, as well as pricing negotiations and the value of developing new healthcare interventions.

Keywords: health economics; vaccines.

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Conflict of interest statement

Competing interests: None declared.

Figures
Figure 1

(A) Net health impact in…

Figure 1

(A) Net health impact in Gavi-eligible countries. (B) Net health impact in Gavi-eligible…

Figure 1

(A) Net health impact in Gavi-eligible countries. (B) Net health impact in Gavi-eligible countries after country-specific subsidies. DALYs, disability-adjusted life years; HPV, human papillomavirus; MICs, middle-income countries.