Costs of delivering human papillomavirus vaccination to schoolgirls in Mwanza Region, Tanzania

BMC Medicine

Deborah Watson-Jones³  Richard Hayes⁷  Saidi Kapiga⁷  David A Ross⁷  Raymond Hutubessy⁶  W John Edmunds⁷  Selephina Soteli²  John Changalucha⁵  Fern Terris-Prestholt⁴  Wilm Quentin¹ 

[1] Department of Health Care Management, Berlin University of Technology, Straße des 17 Juni 135, Berlin, 10623, Germany;Mwanza Intervention Trials Unit, National Institute for Medical Research, PO Box 11936, Mwanza, Tanzania;Department of Clinical Research, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK;Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK;Mwanza Research Centre, National Institute for Medical Research, PO Box 1462, Mwanza, Tanzania;Initiative for Vaccines Research, World Health Organization, Avenue Appia, 1211 Geneva 27, Switzerland;Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK

关键词: uterine cervical neoplasms;    economics papillomavirus vaccines;    costs and cost analysis;    Africa;   

Others  :  857304
DOI  :  10.1186/1741-7015-10-137

 received in 2012-06-02, accepted in 2012-11-13,  发布年份 2012

【 摘 要 】

Background

Cervical cancer is the leading cause of female cancer-related deaths in Tanzania. Vaccination against human papillomavirus (HPV) offers a new opportunity to control this disease. This study aimed to estimate the costs of a school-based HPV vaccination project in three districts in Mwanza Region (NCT ID: NCT01173900), Tanzania and to model incremental scaled-up costs of a regional vaccination program.

Methods

We first conducted a top-down cost analysis of the vaccination project, comparing observed costs of age-based (girls born in 1998) and class-based (class 6) vaccine delivery in a total of 134 primary schools. Based on the observed project costs, we then modeled incremental costs of a scaled-up vaccination program for Mwanza Region from the perspective of the Tanzanian government, assuming that HPV vaccines would be delivered through the Expanded Programme on Immunization (EPI).

Results

Total economic project costs for delivering 3 doses of HPV vaccine to 4,211 girls were estimated at about US$349,400 (including a vaccine price of US$5 per dose). Costs per fully-immunized girl were lower for class-based delivery than for age-based delivery. Incremental economic scaled-up costs for class-based vaccination of 50,290 girls in Mwanza Region were estimated at US$1.3 million. Economic scaled-up costs per fully-immunized girl were US$26.41, including HPV vaccine at US$5 per dose. Excluding vaccine costs, vaccine could be delivered at an incremental economic cost of US$3.09 per dose and US$9.76 per fully-immunized girl. Financial scaled-up costs, excluding costs of the vaccine and salaries of existing staff were estimated at US$1.73 per dose.

Conclusions

Project costs of class-based vaccination were found to be below those of age-based vaccination because of more eligible girls being identified and higher vaccine uptake. We estimate that vaccine can be delivered at costs that would make HPV vaccination a very cost-effective intervention. Potentially, integrating HPV vaccine delivery with cost-effective school-based health interventions and a reduction of vaccine price below US$5 per dose would further reduce the costs per fully HPV-immunized girl.

【 授权许可】

   
2012 Quentin et al; licensee BioMed Central Ltd.

【 图 表 】

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