Standardizing Cost-Effectiveness Evidence for Cancer Prevention: A Case Study Analysis of HPV Vaccination

Area of Science:

• Global Health Economics
• Health Policy Research
• Cancer Prevention Economics

Background:

• Cervical cancer is a leading cause of mortality, disproportionately affecting low- and middle-income countries (LMICs).
• Comparing economic evaluations across LMICs is challenging due to varying currencies, price levels, and willingness-to-pay (WTP) thresholds.
• Traditional Incremental Cost-Effectiveness Ratios (ICERs) lack standardization for cross-country comparisons.

Purpose of the Study:

• To introduce a standardized Cost-Effectiveness Ratio (CER) for comparing economic evaluations across diverse global settings.
• To develop a unitless, income-adjusted metric for health intervention cost-effectiveness.
• To facilitate evidence-based prioritization of investments in global health initiatives.

Main Methods:

• Conducted a rapid review of HPV vaccination economic evaluations (2022-2025).
• Extracted original ICERs and WTP thresholds from diverse countries for a case study.
• Converted all monetary values to 2024 US Dollars, ensuring analytical integrity for WTP thresholds.

Main Results:

• The CER metric reveals significant differences in the economic favorability of vaccination strategies, e.g., China (CER=0.0002) vs. Japan (CER=0.20).
• Programs in Thailand and the Philippines demonstrate over twice the relative economic value compared to Japan.
• Nuanced comparisons, such as single- vs. two-dose HPV vaccination, show comparable value in lower-middle-income settings.

Conclusions:

• The CER is a simple, powerful tool for standardizing incomparable economic data.
• Provides robust evidence for international funders and policymakers to prioritize investments in LMICs.
• Promotes health equity and strengthens the case for accelerating global HPV vaccination efforts by reframing affordability.