Is HPV vaccination cost effective? – PATH

While HPV vaccine is cost effective, affordability can still be a challenge, especially for middle-income countries that are no longer eligible for subsidized pricing via Gavi, the Vaccine Alliance. For instance, Kenya may soon transition away from Gavi support and see its vaccination program costs increaseexceeding US$10 million per year for HPV, the study demonstrated. Moreover, countries face competing health needs and may sometimes need to prioritize one intervention over anothermeaning, even a cost-effective vaccination program may get skipped due to affordability limitations.

It's important to reassess cost-effectiveness as the HPV vaccine landscape and country circumstances change. Gavi transitions can impact affordability and vaccine pricing can change. New vaccines can enter the global market; for instance, Cecolin, a lower priced HPV vaccine, received WHO prequalification in 202111 years after the first HPV vaccines were prequalified. And vaccination recommendations can evolve; in 2022 the WHOs Strategic Advisory Group of Experts on Immunization endorsed a single-dose HPV vaccination schedule as an alternative to the two-dose schedule, which impacts how much vaccine a country needs to procure to protect girls and women. HPV vaccination programs in Kenya and the Philippines, for instance, predate Cecolins approval and the single-dose endorsementand our research shows that a product or schedule switch could be more cost effective or even cost saving in these countries.

Product choice in particular influences the degree of cost effectiveness. Pricing is of course a concernGARDASIL 9, for instance, which at the time of study cost more than other vaccine options and isnt supported by Gavi, generally wasnt cost effective for the countries studied. But in addition to price variations, the virus types the vaccine protects against matter. The currently available vaccines directly protect against the two major virus types that cause cancer, and some potentially offer cross-protection against additional virus types not included in the vaccine. Type of protection offered impacts health outcomes, which in turn impacts cost effectiveness.

For instance, our research showed that in Mongolia, Cervarix may offer better value for money than GARDASIL even though Cervarix was priced higher at the time of study. This is because Cervarix has shown cross protection against some virus types not included in the vaccine but that were prevalent in a notable percentage of cervical cancer cases in Mongolia. Similarly, the study in Kenya showed that Cecolin provides better value for money when cross-protection is not considered, whereas Cervarix is the most cost-effective choice when it is considered.

Vaccines are one of the best buys in public health but that doesnt mean countries should say yes to every new vaccine or schedule change that comes along, said Clint Pecenka, PhD, Director of Health Economics at PATH. HPV vaccination saves lives and improves healthand health economic assessments like cost-effectiveness analyses can help ensure it makes good financial sense, too. In the case of HPV vaccination, research shows that vaccination is often a wise economic choice for countries.

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Is HPV vaccination cost effective? - PATH