Evaluation of cost-effectiveness of HPV vaccine in terms of inclusion of the national vaccine program

The aim of this study is to evaluate cost effectiveness of HPV Vaccines in Turkey in terms of national vaccination program. Microsoft Excel-based PRIME model was used in the study. Two main scenarios (Scenario-1 and Scenario-2) were planned by modeling the vaccination of girls at the age of 12 with vaccines with two-valent or four-valent and nine-valent vaccines. The scenarios are dealt with separately within the framework of social security institution and social perspectives. Health outcomes corresponding to unit cost in each scenario were compared in terms of DALY saved. ICER for Scenario-1 is 2.231 $, Scenario-2 is 2.342 $. According to WHO criteria, both interventions can be described as "very cost-effective". The ICER of the scenarios has been calculated as 2.592 $. Discount rate is the most important factor affecting ICER in sensitivity analysis. Vaccine Efficiency and Cervical Cancer Rate of Subtypes can be shown as the second factor, and the vaccine price can be shown as the third factor. The annual cost to SSI will be 15,667,533 $ for scenario-1 and 23,583,760 for scenario-2. For scenario-1, for vaccine prices up to $ 54, the intervention is very cost-effective. Prices above $ 167 are not cost-effective. For scenario 2, the intervention is very cost-effective for vaccine prices up to $ 78. Prices above $ 242 are not cost-effective. The main reason for cost-effectiveness is the life years gained by preventing deaths. Using a model approved by WHO and studied with the data of many countries, cross-country comparable outputs have been generated. While making decisions, the benefits of the intervention to the individual and society should not be acted upon. The interventions should be decided with a holistic view.