In:
PLOS ONE, Public Library of Science (PLoS), Vol. 16, No. 12 ( 2021-12-20), p. e0260808-
Abstract:
Cost-effectiveness analysis (CEA) is a well-known, but resource intensive, method for comparing the costs and health outcomes of health interventions. To build on available evidence, researchers are developing methods to transfer CEA across settings; previous methods do not use all available results nor quantify differences across settings. We conducted a meta-regression analysis of published CEAs of human papillomavirus (HPV) vaccination to quantify the effects of factors at the country, intervention, and method-level, and predict incremental cost-effectiveness ratios (ICERs) for HPV vaccination in 195 countries. We used 613 ICERs reported in 75 studies from the Tufts University’s Cost-Effectiveness Analysis (CEA) Registry and the Global Health CEA Registry, and extracted an additional 1,215 one-way sensitivity analyses. A five-stage, mixed-effects meta-regression framework was used to predict country-specific ICERs. The probability that HPV vaccination is cost-saving in each country was predicted using a logistic regression model. Covariates for both models included methods and intervention characteristics, and each country’s cervical cancer burden and gross domestic product per capita. ICERs are positively related to vaccine cost, and negatively related to cervical cancer burden. The mean predicted ICER for HPV vaccination is 2017 US$4,217 per DALY averted (95% uncertainty interval (UI): US$773–13,448) globally, and below US$800 per DALY averted in 64 countries. Predicted ICERs are lowest in Sub-Saharan Africa and South Asia, with a population-weighted mean ICER across 46 countries of US$706 per DALY averted (95% UI: $130–2,245), and across five countries of US$489 per DALY averted (95% UI: $90–1,557), respectively. Meta-regression analyses can be conducted on CEA, where one-way sensitivity analyses are used to quantify the effects of factors at the intervention and method-level. Building on all published results, our predictions support introducing and expanding HPV vaccination, especially in countries that are eligible for subsidized vaccines from GAVI, the Vaccine Alliance, and Pan American Health Organization.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0260808
DOI:
10.1371/journal.pone.0260808.g001
DOI:
10.1371/journal.pone.0260808.g002
DOI:
10.1371/journal.pone.0260808.g003
DOI:
10.1371/journal.pone.0260808.t001
DOI:
10.1371/journal.pone.0260808.t002
DOI:
10.1371/journal.pone.0260808.t003
DOI:
10.1371/journal.pone.0260808.s001
DOI:
10.1371/journal.pone.0260808.s002
DOI:
10.1371/journal.pone.0260808.s003
DOI:
10.1371/journal.pone.0260808.s004
DOI:
10.1371/journal.pone.0260808.s005
DOI:
10.1371/journal.pone.0260808.s006
DOI:
10.1371/journal.pone.0260808.s007
DOI:
10.1371/journal.pone.0260808.s008
DOI:
10.1371/journal.pone.0260808.r001
DOI:
10.1371/journal.pone.0260808.r002
DOI:
10.1371/journal.pone.0260808.r003
DOI:
10.1371/journal.pone.0260808.r004
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2021
detail.hit.zdb_id:
2267670-3
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