The potential cost-effectiveness of adding a human papillomavirus vaccine to the cervical cancer screening programme in South Africa

Vaccine. 2009 Oct 19;27(44):6196-202. doi: 10.1016/j.vaccine.2009.08.004. Epub 2009 Aug 19.


This study was designed to answer the question of whether a cervical cancer prevention programme that incorporates a human papillomavirus (HPV) vaccine is potentially more cost-effective than the current strategy of screening alone in South Africa. We developed a static Markov state transition model to describe the screening and management of cervical cancer within the South African context. The incremental cost-effectiveness ratio of adding HPV vaccination to the screening programme ranged from US $1078 to 1460 per quality-adjusted life year (QALY) gained and US$3320-4495 per life year saved, mainly depending on whether the study was viewed from a health service or a societal perspective. Using discounted costs and benefits, the threshold analysis indicated that a vaccine price reduction of 60% or more would make the vaccine plus screening strategy more cost-effective than the screening only approach. To address the issue of affordability and cost-effectiveness, the pharmaceutical companies need to make a commitment to price reductions.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Cost-Benefit Analysis
  • Female
  • Humans
  • Markov Chains
  • Middle Aged
  • Models, Economic*
  • Papillomavirus Infections / economics
  • Papillomavirus Infections / epidemiology
  • Papillomavirus Infections / prevention & control*
  • Papillomavirus Vaccines / economics*
  • Quality-Adjusted Life Years
  • South Africa / epidemiology
  • Uterine Cervical Neoplasms / economics
  • Uterine Cervical Neoplasms / epidemiology
  • Uterine Cervical Neoplasms / prevention & control*
  • Young Adult


  • Papillomavirus Vaccines