Economic evaluation of the one-dose HPV vaccination program in Nigeria
This study retrospectively examines the cost-effectiveness of the national HPV vaccination program using the program cost and coverage data in Nigeria. We conducted a cost-effectiveness analysis of the HPV vaccination program compared with no vaccination in Nigeria, adopting both health system and societal perspectives. A static Markov model simulating HPV infection and cervical cancer outcomes was developed for a cohort of girls aged 9-14 years, followed until age 100. The model comprised primarily the following health states: susceptible, cervical cancer, and death. It further incorporated three additional pathways for patients with cervical cancer, including those with successful treatment, with treatment failure, and with no treatment. The incremental cost-effectiveness ratio (ICER) was estimated at $268.67 per quality-adjusted life year (QALY) gained from the health system perspective and $217.85 per QALY gained from the societal perspective. Both ICERs were well below the cost-effectiveness threshold of one-time GDP per capita in Nigeria ($806.95). Key drivers of cost-effectiveness included vaccine cost, treatment success rate, cervical cancer treatment coverage, and cervical cancer utility values. The single-dose HPV vaccination program is highly cost-effective in Nigeria, compared to the status quo of no vaccination. To ensure long-term sustainability, the Nigerian government should strengthen financing mechanisms and the healthcare system to support the program. Single dose HPV vaccination is cost-effective in Nigeria. It is crucial to obtain sustainable vaccine financing and improve treatment to maintain the program impact.
