Peer-reviewed article
Cost effectiveness of female HPV vaccines for routine childhood immunisation schedule in Türkiye.
Şahin ÇE, Karabey S ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study evaluates whether adding HPV vaccines to Türkiye's childhood immunisation program is cost-effective. The analysis compared two vaccine strategies for 12-year-old girls using WHO guidelines and found both approaches cost-effective by international standards. The annual program cost would be USD 15.7 to 23.6 million, but the health benefits justify this expense. Both strategies would reduce cervical cancer cases and deaths while representing good value for healthcare resources.
Key points
- Bivalent/quadrivalent vaccine scenario cost USD 2,231 per disability-adjusted life year averted, classified as 'very cost-effective'
- Nonavalent vaccine scenario cost USD 2,342 per disability-adjusted life year averted, also 'very cost-effective'
- Annual program costs estimated at USD 15.7 million (Scenario 1) and USD 23.6 million (Scenario 2)
- Vaccination remained cost-effective at prices up to USD 54-78 depending on vaccine type
- Discount rate, vaccine efficacy, HPV subtype distribution, and vaccine price were key factors affecting cost-effectiveness
Limitations
This is a modelling study based on projected outcomes rather than real-world implementation data, so actual costs and health effects may differ. The analysis does not address access equity, uptake rates, or non-cervical HPV-related cancers in males.
Abstract
Objective To evaluate the cost-effectiveness of introducing Human Papillomavirus (HPV) vaccination into Türkiye's National Immunization Program. Methods The analysis employed the WHO-endorsed PRIME model in Microsoft Excel. Two vaccination strategies were simulated for 12-year-old girls: Scenario 1 (bivalent or quadrivalent vaccine) and Scenario 2 (nonavalent vaccine). Each scenario was assessed from both the Social Security Institution (SGK) and societal perspectives. Incremental cost-effectiveness ratios (ICERs) were calculated per disability-adjusted life year (DALY) averted, with sensitivity analyses conducted to test model robustness. Results Scenario 1 yielded an ICER of USD 2,231 per DALY averted, while Scenario 2 produced an ICER of USD 2,342. The incremental ICER of Scenario 2 versus Scenario 1 was USD 2,592. According to WHO cost-effectiveness thresholds, both scenarios were classified as "very cost-effective." Sensitivity analyses identified the discount rate as the most influential factor, followed by vaccine efficacy, HPV subtype distribution, and vaccine price. The annual program cost to SGK was estimated at USD 15.7 million for Scenario 1 and USD 23.6 million for Scenario 2. Vaccination remained highly cost-effective at prices up to USD 54 (Scenario 1) and USD 78 (Scenario 2), but not cost-effective above USD 167 and USD 242, respectively. Conclusions HPV vaccination is highly cost-effective in Türkiye, with both strategies offering substantial health gains and favorable ICERs well below national GDP per capita. Adoption of a national HPV vaccination program would likely reduce cervical cancer morbidity and mortality while representing an efficient use of healthcare resources.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
Problem
High burden of cervical cancer in girls and women from human papillomavirus infection in Türkiye
- Intervention
- Introduction of HPV vaccination for 12-year-old girls into the National Immunization Program using bivalent/quadrivalent vaccine (Scenario 1) or nonavalent vaccine (Scenario 2)
- Population
- 12-year-old girls in Türkiye
Key finding
Scenario 1 ICER USD 2,231 per DALY averted, classified as very cost-effective