Cost-effectiveness analysis of human papillomavirus vaccination in South Africa accounting for human immunodeficiency virus prevalence

Table 5 Base case results: overall 12-years-old girls cohort

Outcomes	Screening	Screening + HPV vaccination	Incremental value	ICER (ZAR/QALY)
NO DISCOUNTING
Total costs	ZAR 1 649 427 899	ZAR 985 679 708	ZAR −663 748 191
Vaccine cost	ZAR 0	ZAR 628 612 762	ZAR 628 612 762
Screening cost	ZAR 149 297 117	ZAR 153 547 788	ZAR 4 250 671
CIN1 treatment cost	ZAR 10 577 161	ZAR 3 746 430	ZAR −6 830 731
CIN2/3 treatment cost	ZAR 8 262 222	ZAR 1 813 136	ZAR −6 449 086
CC treatment cost	ZAR 1 481 291 399	ZAR 197 959 592	ZAR −1 283 331 807
Life years	27 173 430	27 230 436	57 006
CC cases	10 244	1 376	−8 869
CC deaths	6 313	877	−5 436
QALYs	26 554 764	26 623 034	68 270	V + S dominant
DISCOUNTED AT 5 %
Total costs	ZAR 221 807 577	ZAR 692 872 271	ZAR 471 064 695
Vaccine cost	ZAR 0	ZAR 628 612 762	ZAR 628 612 762
Screening cost	ZAR 35 277 421	ZAR 36 453 101	ZAR 1 175 681
CIN1 treatment cost	ZAR 2 775 840	ZAR 1 007 252	ZAR −1 768 588
CIN2/3 treatment cost	ZAR 2 541 718	ZAR 553 386	ZAR −1 988 332
CC treatment cost	ZAR 181 212 598	ZAR 26 245 770	ZAR −1 988 332
Life years	1 283 817	9 154 639	4 633
QALYs	8 904 494	8 910 240	5 746	ZAR 81 978

CC, cervical cancer; CIN, cervical intraepithelial neoplasia; CIN1, CIN grade 1; CIN2/3, CIN grade 2 or 3; QALYs, quality-adjusted life-years; ZAR, South African Rand; HPV, human papillomavirus; ICER, incremental cost-effectiveness ratio; V + S, HPV vaccination + screening

ISSN: 1471-2334