Table 3.
Cost (US$) per DALY averted for alternative deterministic scenarios (comparator = no vaccine)
| Vaccine | Scenario | Societal perspective | % change | Comment* |
|---|---|---|---|---|
| CECOLIN | Central inputs (US$ 2.9 per dose for 2 doses with no cross-protection assumption) | 242 | - | Favourable |
| With catch-up campaign | 312 | 29% | Favourable | |
| Schedule = 1 dose with full 2 doses efficacy assumption | 102 | -58% | Favourable | |
| Schedule = 1 dose with efficacy = 2 doses efficacy x 0.8 assumption | 141 | -42% | Favourable | |
| Vaccine efficacy reported by ICO/IARC for the African continent (www.hpvcentre.net) (1 dose efficacy = 53,76% and 2 doses efficacy = 67,20%) | 116 | -52% | Favourable | |
| Cost of cervical cancer treatment 20% lower than the base case value assumption | 253 | 5% | Favourable | |
| Cost of cervical cancer treatment 20% higher than the base case value assumption | 231 | -5% | Favourable | |
| Higher dropout rate between first and second dose assumption. Coverage of second dose assumed in baseline scenario halved | 197 | -19% | Favourable | |
| Central inputs (US$ 2.9 per dose for 2 doses with cross-protection assumption) | 176 | - | Favourable | |
| With catch-up campaign | 230 | 31% | Favourable | |
| Schedule = 1 dose with full 2 doses efficacy assumption | 67 | -62% | Favourable | |
| Schedule = 1 dose with efficacy = 2 doses efficacy x 0.8 assumption | 98 | -44% | Favourable | |
| Vaccine efficacy reported by ICO/IARC for the African continent (www.hpvcentre.net) (1 dose efficacy = 56,12% and 2 doses efficacy = 70,14%) | 109 | -38% | Favourable | |
| Cost of cervical cancer treatment 20% lower than the base case value assumption | 187 | 6% | Favourable | |
| Cost of cervical cancer treatment 20% higher than the base case value assumption | 165 | -6% | Favourable | |
| Higher dropout rate between first and second dose assumption. Coverage of second dose assumed in baseline scenario halved | 141 | -20% | Favourable | |
| CERVARIX | Central inputs (US$ 4.6 per dose for 2 doses with no cross-protection assumption) | 396 | - | Favourable |
| With catch-up campaign | 476 | 20% | Favourable | |
| Schedule = 1 dose with full 2 doses efficacy assumption | 181 | -54% | Favourable | |
| Schedule = 1 dose with efficacy = 2 doses efficacy x 0.8 assumption | 239 | -40% | Favourable | |
| Vaccine efficacy reported by ICO/IARC for the African continent (www.hpvcentre.net) (1 dose efficacy = 53,05% and 2 doses efficacy = 66,32%) | 206 | -48% | Favourable | |
| Cost of cervical cancer treatment 20% lower than the base case value assumption | 406 | 3% | Favourable | |
| Cost of cervical cancer treatment 20% higher than the base case value assumption | 384 | -3% | Favourable | |
| Higher dropout rate between first and second dose assumption. Coverage of second dose assumed in baseline scenario halved | 326 | -18% | Favourable | |
| Central inputs (US$ 4.6 per dose for 2 doses with cross-protection assumption) | 198 | - | Favourable | |
| With catch-up campaign | 244 | 23% | Favourable | |
| Schedule = 1 dose with full 2 doses efficacy assumption | 78 | -61% | Favourable | |
| Schedule = 1 dose with efficacy = 2 doses efficacy x 0.8 assumption | 111 | -44% | Favourable | |
| Vaccine efficacy reported by ICO/IARC for the African continent (www.hpvcentre.net) (1 dose efficacy = 68,01% and 2 doses efficacy = 85,01%) | 148 | -25% | Favourable | |
| Cost of cervical cancer treatment 20% lower than the base case value assumption | 209 | 6% | Favourable | |
| Cost of cervical cancer treatment 20% higher than the base case value assumption | 188 | -5% | Favourable | |
| Higher dropout rate between first and second dose assumption. Coverage of second dose assumed in baseline scenario halved | 159 | -20% | Favourable | |
| GARDASIL-4 | Central inputs (US$ 4.5 per dose for 2 doses with no cross-protection assumption) | 369 | - | Favourable |
| With catch-up campaign | 448 | 21% | Favourable | |
| Schedule = 1 dose with full 2 doses efficacy assumption | 167 | -55% | Favourable | |
| Schedule = 1 dose with efficacy = 2 doses efficacy x 0.8 assumption | 223 | -40% | Favourable | |
| Vaccine efficacy reported by ICO/IARC for the African continent (www.hpvcentre.net) (1 dose efficacy = 53,43% and 2 doses efficacy = 66,78%) | 188 | -49% | Favourable | |
| Cost of cervical cancer treatment 20% lower than the base case value assumption | 380 | 3% | Favourable | |
| Cost of cervical cancer treatment 20% higher than the base case value assumption | 358 | -3% | Favourable | |
| Higher dropout rate between first and second dose assumption. Coverage of second dose assumed in baseline scenario halved | 304 | -18% | Favourable | |
| Central inputs (US$ 4.5 per dose for 2 doses with cross-protection assumption) | 275 | - | Favourable | |
| With catch-up campaign | 336 | 22% | Favourable | |
| Schedule = 1 dose with full 2 doses efficacy assumption | 118 | -57% | Favourable | |
| Schedule = 1 dose with efficacy = 2 doses efficacy x 0.8 assumption | 161 | -41% | Favourable | |
| Vaccine efficacy reported by ICO/IARC for the African continent (www.hpvcentre.net) (1 dose efficacy = 54,94% and 2 doses efficacy = 68,67%) | 181 | -34% | Favourable | |
| Cost of cervical cancer treatment 20% lower than the base case value assumption | 285 | 4% | Favourable | |
| Cost of cervical cancer treatment 20% higher than the base case value assumption | 264 | -4% | Favourable | |
| Higher dropout rate between first and second dose assumption. Coverage of second dose assumed in baseline scenario halved | 224 | -19% | Favourable | |
| GARDASIL-9 | Central inputs (US$ 25 per dose for 2 doses) | 988 | - | Borderline |
| With catch-up campaign | 1086 | 10% | Borderline | |
| Schedule = 1 dose with full 2 doses efficacy assumption | 483 | -51% | Favourable | |
| Schedule = 1 dose with efficacy = 2 doses efficacy x 0.8 assumption | 618 | -37% | Borderline | |
| Vaccine price = Highest (US$ 178.14 per dose) | 7136 | 622% | Unfavourable | |
| Vaccine efficacy reported by ICO/IARC for the African continent (www.hpvcentre.net) (1 dose efficacy = 70,54% and 2 doses efficacy = 88,17%) | 818 | -17% | Borderline | |
| Cost of cervical cancer treatment 20% lower than the base case value assumption | 999 | 1% | Borderline | |
| Cost of cervical cancer treatment 20% higher than the base case value assumption | 977 | -1% | Borderline | |
| Higher dropout rate between first and second dose assumption. Coverage of second dose assumed in baseline scenario halved | 823 | -17% | Borderline |
* Favourable, borderline, and unfavourable cost-effectiveness ratios compared to no vaccination