Cost-Effectiveness of Bivalent, Quadrivalent, and Nonavalent HPV Vaccination in South Africa

Michaeli, Daniel Tobias; Stoycheva, Sophia; Marcus, Simon Mashudu; Zhang, Wenjia; Michaeli, Julia Caroline; Michaeli, Thomas

doi:10.1007/s40261-022-01138-6

Cited by 9 publications

(12 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our findings are consistent with several economic evaluations that have demonstrated the cost-effectiveness of single-visit screening and treatment, HPV DNA testing, and HPV vaccination in Sub-Saharan Africa ( 44 , 45 , 62 – 65 ). For example, a prior study by Zimmermann et al.…”

Section: Discussionsupporting

confidence: 92%

“…Aggregated costs of cervical cancer screening, triage, and the treatment and care of pre-cancer, cervical cancer, and HIV were derived from published studies ( 37 – 39 , 41 , 43 – 47 , 49 – 51 ). HPV vaccination costs accounted for the 9vHPV vaccine product, with an additional 5% for wastage, 4.5% for transportation and handling, and 15% for distribution and delivery, based on prior studies ( 43 , 44 , 50 , 51 ). Costs were converted and inflated to 2022 US dollars.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Cost-effectiveness of single-visit cervical cancer screening in KwaZulu-Natal, South Africa: a model-based analysis accounting for the HIV epidemic

Tran,

Hathaway,

Broshkevitch

et al. 2024

Front. Oncol.

View full text Add to dashboard Cite

IntroductionWomen living with human immunodeficiency virus (WLHIV) face elevated risks of human papillomavirus (HPV) acquisition and cervical cancer (CC). Coverage of CC screening and treatment remains low in low-and-middle-income settings, reflecting resource challenges and loss to follow-up with current strategies. We estimated the health and economic impact of alternative scalable CC screening strategies in KwaZulu-Natal, South Africa, a region with high burden of CC and HIV.MethodsWe parameterized a dynamic compartmental model of HPV and HIV transmission and CC natural history to KwaZulu-Natal. Over 100 years, we simulated the status quo of a multi-visit screening and treatment strategy with cytology and colposcopy triage (South African standard of care) and six single-visit comparator scenarios with varying: 1) screening strategy (HPV DNA testing alone, with genotyping, or with automated visual evaluation triage, a new high-performance technology), 2) screening frequency (once-per-lifetime for all women, or repeated every 5 years for WLHIV and twice for women without HIV), and 3) loss to follow-up for treatment. Using the Ministry of Health perspective, we estimated costs associated with HPV vaccination, screening, and pre-cancer, CC, and HIV treatment. We quantified CC cases, deaths, and disability-adjusted life-years (DALYs) averted for each scenario. We discounted costs (2022 US dollars) and outcomes at 3% annually and calculated incremental cost-effectiveness ratios (ICERs).ResultsWe projected 69,294 new CC cases and 43,950 CC-related deaths in the status quo scenario. HPV DNA testing achieved the greatest improvement in health outcomes, averting 9.4% of cases and 9.0% of deaths with one-time screening and 37.1% and 35.1%, respectively, with repeat screening. Compared to the cost of the status quo ($12.79 billion), repeat screening using HPV DNA genotyping had the greatest increase in costs. Repeat screening with HPV DNA testing was the most effective strategy below the willingness to pay threshold (ICER: $3,194/DALY averted). One-time screening with HPV DNA testing was also an efficient strategy (ICER: $1,398/DALY averted).ConclusionsRepeat single-visit screening with HPV DNA testing was the optimal strategy simulated. Single-visit strategies with increased frequency for WLHIV may be cost-effective in KwaZulu-Natal and similar settings with high HIV and HPV prevalence.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Methodsmentioning

confidence: 99%

Cost-effectiveness of single-visit cervical cancer screening in KwaZulu-Natal, South Africa: a model-based analysis accounting for the HIV epidemic

Tran,

Hathaway,

Broshkevitch

et al. 2024

Front. Oncol.

View full text Add to dashboard Cite

show abstract

“…For other batches of intermediates, the detection of the content item is omitted. For the five batches in the process of change, without the support of scientific argumentation reports, it is impossible to judge whether the detection frequency is reasonable [26].…”

Section: Experimental Casementioning

confidence: 99%

Artificial Intelligence-Based Drug Production Quality Management Data

2022

Mathematical Problems in Engineering

View full text Add to dashboard Cite

As a special commodity, medicine plays a vital role in people’s healthy life. The basic effects of drugs are excitation and inhibition. Under the action of drugs, any function that can enhance or increase the function of the body’s original tissues and organs is called excitement. On the contrary, any function that can weaken or reduce the function of the original tissues and organs of the body is called inhibition. The nature of action of drugs has three aspects: regulatory function; antipathogen and antitumor; and complementary therapy. If there is a problem with the quality and safety of medicines, it is tantamount to making money and killing people. Based on artificial intelligence, this paper analyzes the current situation and improvement strategies of quality management in pharmaceutical production management enterprises and proposes how to reduce the risk of drug safety with the assistance of artificial intelligence technology. The experimental results in this paper show that the sales of heparin sodium APIs were 2.099 billion yuan, accounting for 91.6% of the operating income in 2015, when company A had not conducted a drug risk assessment in 2015. After the outbreak of drug risks, the sales in 2016 were 1.743 billion yuan, accounting for 77.1% of the operating income in 2016. After the final implementation of the measures, the sales in 2019 were 4.743 billion yuan, accounting for 329.1% of the operating income in 2016. The research method in this paper can improve the hidden safety problems of drugs more efficiently, and it can improve the profit while ensuring the safety.

show abstract

“…4 The greater cost effectiveness of 9vHPV has been confirmed in low-middle-income countries (LMICs) of Indonesia (incremental cost-effectiveness ratio [ICER] of USD830 per quality adjusted life year [QALY]) 5 and South Africa (ICER of USD796 c /QALY). 6 …”

mentioning

confidence: 99%

“…For prevention of precancerous HPV and HPV-associated cancer, the ICER was USD8335 c /QALY in the Netherlands in 2020, 11 and USD6,737 c /QALY in Sweden, including additional prevention of genital warts, in 2018, 12 approximately nine-fold that of female-only vaccination campaigns in LMICs. 5 , 6 Many similar analyses exclude treatment costs of genital warts. In Sweden, prevention of genital warts increased the QALYs from 5600 to 6,010, further decreasing accumulated net costs from USD236 million c to USD 210 million c .…”

mentioning

confidence: 99%