Table 1.
Resources required per screened woman by intervention arm, with associated costs in 2019 (€ 1 = 10.5912 SEK)
| Pap smear (n = 18,393) | HPV self-sampling (n = 17,997) | ||||
|---|---|---|---|---|---|
| Unit Cost (€) | Units | Costs (€) | Units | Costs (€) | |
| Primary screening | |||||
| Pap smear cytological analysis | 25 | 6364 | 159,100 | ||
| Midwife appointment for sampling | 98 | 6364 | 623,672 | ||
| First HPV self-sampling kit, return and HPV test (including postal fees) | 27 | 7997 | 215,919 | ||
| 2nd HPV self-sampling kit, return and HPV test (including postal fees) | 27 | 501 | 13,527 | ||
| Total cost of primary screening | 782,772 | 229,446 | |||
| Screened women | 6364 | 7997 | |||
| Abnormal cytology in need of clinical follow-up | 222 | ||||
| 2nd HPV-positive in need of clinical follow-up | 355 | ||||
| Incremental effect (screened women) | 1633 | ||||
| Cost per screened woman | 123 | 29 | |||
| ICER per extra screened woman | − 339 | ||||
| Clinical follow-up | |||||
| Pap smear cytological analysis | 25 | 238 | 5950 | 428 | 10,700 |
| HPV analysis* | 38 | 173 | 6574 | 46 | 1748 |
| Midwife appointment for sampling | 98 | 166 | 16,268 | 4 | 392 |
| Colposcopy appointment | 470 | 114 | 53,580 | 384 | 180,480 |
| Biopsy histological analysis | 147 | 114 | 16,758 | 367 | 53,949 |
| Total cost of clinical follow-up | 99,130 | 247,269 | |||
| Total cost of primary screening + clinical follow-up | 881,902 | 476,715 | |||
| CIN2+ | 68 | 175 | |||
| Incremental effect (CIN2+) | 107 | ||||
| Cost per woman with CIN2+ | 12,969 | 2724 | |||
| ICER per extra detected woman with CIN2+ | − 3787 | ||||
| Sensitivity analysis HPV vs. Pap smear (ICER per extra detected woman with CIN2+) | |||||
| Efficacy parameters | |||||
| Participation rate + 25% Pap smear | 7955 | −5451 | |||
| Participation rate + 25% HPV self-sampling | − 3124 | 9996 | |||
| Participation rate − 25% Pap smear | 4773 | −111 | |||
| Participation rate − 25% HPV self-sampling | − 4129 | 5998 | |||
| Screening cost variation | |||||
| HPV self-sampling + 25% | 34 | − 3092 | |||
| HPV self-sampling −25% | 20 | − 4160 | |||
| Pap smear cytological analysis + 25% | 32 | − 3990 | |||
| Pap smear cytological analysis −25% | 19 | − 3262 | |||
| Midwife appointment + 25% | 122 | − 5076 | |||
| Midwife appointment −25% | 73 | − 2176 | |||
| Midwife appointment −50% | 49 | − 727 | |||
*Total cost of HPV test including HPV kit and analysis performed at the HPV laboratory, Uppsala University and transfer of the results to the database at the Department of Cytology and Pathology, Uppsala University Hospital