PATH, Seattle, WA, USA.
PATH, Seattle, WA, USA.
Vaccine. 2023 Nov 30;41(49):7435-7443. doi: 10.1016/j.vaccine.2023.11.008. Epub 2023 Nov 10.
There are concerns from immunization program planners about high delivery costs for human papillomavirus (HPV) vaccine. Most prior research evaluated costs of HPV vaccine delivery during demonstration projects or at introduction, showing relatively high costs, which may not reflect the costs beyond the pilot or introduction years. This study sought to understand the operational context and estimate delivery costs for HPV vaccine in six national programs, beyond their introduction years.
Operational research and microcosting methods were used to retrospectively collect primary data on HPV vaccination program activities in Ethiopia, Guyana, Rwanda, Senegal, Sri Lanka, and Uganda. Data were collected from the national level and a sample of subnational administrative offices and health facilities. Operational data collected were tabulated as percentages and frequencies. Financial costs (monetary outlays) and economic costs (financial plus opportunity costs) were estimated, as was the cost per HPV vaccine dose delivered. Costing was done from the health system perspective and reported in 2019 United States dollars (US$).
Across the study countries, between 53 % and 99 % of HPV vaccination sessions were conducted in schools. Differences were observed in intensity and frequency with which program activities were conducted and resources used. Mean annual economic costs at health facilities in each country ranged from $1,207 to $3,190, while at the national level these ranged from $7,657 to $304,278. Mean annual HPV vaccine doses delivered per health facility in each country ranged from 162 to 761. Mean financial costs per dose per study country ranged from $0.27 to $3.32, while the economic cost per dose ranged from $3.09 to $17.20.
HPV vaccine delivery costs were lower than at introduction in some study countries. There were differences in the activities carried out for HPV vaccine delivery and the number of doses delivered, impacting the cost estimates.
免疫规划规划人员对人乳头瘤病毒 (HPV) 疫苗的高交付成本表示担忧。大多数先前的研究评估了 HPV 疫苗接种在示范项目或引入期间的成本，显示出相对较高的成本，这可能无法反映试点或引入年份以外的成本。本研究旨在了解 HPV 疫苗在六个国家计划中的运作背景，并估计其引入年份以外的疫苗交付成本。
使用运营研究和微观成本核算方法，回顾性收集了埃塞俄比亚、圭亚那、卢旺达、塞内加尔、斯里兰卡和乌干达 HPV 疫苗接种计划活动的原始数据。数据从国家层面和国家以下行政办事处和卫生设施的样本中收集。收集的运营数据以百分比和频率的形式列出。估计了财务成本（货币支出）和经济成本（财务加机会成本），以及每支 HPV 疫苗剂量的交付成本。成本核算从卫生系统的角度进行，并以 2019 年美元（美元）报告。
在所研究的国家中，53%至 99%的 HPV 疫苗接种会议在学校进行。在开展计划活动和使用资源的强度和频率方面存在差异。每个国家卫生设施的年平均经济成本从 1207 美元到 3190 美元不等，而国家一级的成本从 7657 美元到 304278 美元不等。每个国家卫生设施每年平均接种的 HPV 疫苗剂量从 162 剂到 761 剂不等。每个研究国家的疫苗每支财务成本从 0.27 美元到 3.32 美元不等，而每支经济成本从 3.09 美元到 17.20 美元不等。
在一些研究国家，HPV 疫苗的交付成本低于引入时的成本。HPV 疫苗接种交付所开展的活动和交付的疫苗数量存在差异，这影响了成本估算。
