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Assessment of the Broader Economic Consequences of HPV Prevention from a Government-Perspective: A Fiscal Analytic Approach

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  • Didik Setiawan
  • Nikolaos Kotsopoulos
  • Jan C Wilschut
  • Maarten J Postma
  • Mark P Connolly

Abstract

Background: Cervical cancer poses a substantial burden in terms of morbidity, mortality, and economic losses, especially in low/middle-income countries. HPV vaccination and/or cervical cancer screening among females may reduce the burden of HPV-related diseases, including cervical cancer. However, limited funds may impede the implementation of population-based programmes. Governmental investments in the prevention of infectious disease may have broader economic and fiscal benefits, which are not accounted in conventional economic analyses. This study estimates the broader economic and fiscal impacts of implementing HPV vaccination and/or cervical cancer screening in Indonesia from the perspective of the government. Methods: A government-perspective quantitative analytic framework was applied to assess the Net Present Value (NPV) of investment on cervical cancer prevention strategies including HPV vaccination, cervical screening and its combination in Indonesia. All monetary values were presented in International Dollars (I$). Results: Based on a cohort of 10,000,000 Indonesian 12-year-old females, it was estimated that HPV vaccination and/or cervical cancer screening result in a positive NPV for the Indonesian government. The combination of cervical screening and HPV vaccination generated a substantial reduction of cervical cancer incidence and HPV-related mortality of 87,862 and 19,359, respectively. It was estimated that HPV vaccination in combination with cervical screening is the most favorable option for cervical cancer prevention (NPV I$2.031.786.000), followed by HPV vaccination alone (NPV I$1.860.783.000) and cervical screening alone (NPV I$375.244.000). Conclusion: In addition to clinical benefits, investing in HPV vaccination and cervical screening may yield considerable fiscal benefits for the Indonesian governments due to lifelong benefits resulting from reduction of cervical cancer-related morbidity and mortality.

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  • Didik Setiawan & Nikolaos Kotsopoulos & Jan C Wilschut & Maarten J Postma & Mark P Connolly, 2016. "Assessment of the Broader Economic Consequences of HPV Prevention from a Government-Perspective: A Fiscal Analytic Approach," PLOS ONE, Public Library of Science, vol. 11(8), pages 1-12, August.
    • Handle: RePEc:plo:pone00:0160707
    DOI: 10.1371/journal.pone.0160707
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    References listed on IDEAS

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    1. Naiyana Praditsitthikorn & Yot Teerawattananon & Sripen Tantivess & Supon Limwattananon & Arthorn Riewpaiboon & Saibua Chichareon & Nantakan Ieumwananonthachai & Viroj Tangcharoensathien, 2011. "Economic Evaluation of Policy Options for Prevention and Control of Cervical Cancer in Thailand," PharmacoEconomics, Springer, vol. 29(9), pages 781-806, September.
    2. Mark Connolly & Oleksandr Topachevskyi & Baudouin Standaert & Omayra Ortega & Maarten Postma, 2012. "The Impact of Rotavirus Vaccination on Discounted Net Tax Revenue in Egypt," PharmacoEconomics, Springer, vol. 30(8), pages 681-695, August.
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