Cost-effectiveness analysis of different types of human papillomavirus vaccination combined with a cervical cancer screening program in mainland China

Table 2 Cost-effectiveness analysis and reduction in cervical cancer and warts of each strategy under base-case assumptions based on Monte Carlo simulation of 100,000 trails

Strategy	Discounted costs	Discounted QALYs	IC/IE ($/QALYs)	Cancer reduction incidence (%)	Cancer mortality reduction (%)	HPVhr incidence reduction (%)	Warts incidence reduction (%)
No intervention	25.359	30.858	--	1893.000	348.000	895,739.000	100,676.000
HPV-4 ^a	101.631	30.872	5400.550^f	15.850	18.200	18.130	15.570
HPV-2 ^a	103.205	30.859	Dominated	13.100	13.100	4.170	14.500
HPV-9 ^a	110.203	30.873	5768.350^f	16.270	18.410	20.450	15.560
Screen1 ^{b, c}	116.544	30.867	959,735.859^h 9287.599^g	18.860	19.020	10.400	5.900
Screen1 + HPV-4^c	193.106	30.880	6070.026^f	33.860	35.690	23.640	20.780
Screen1 + HPV-2^c	194.301	30.869	Dominated	32.280	32.280	6.490	19.840
Screen1 + HPV-9^c	201.724	30.881	6275.190^f	34.390	35.950	25.820	20.800
Screen2 ^{b, d}	82.945	30.867	20,372.19^g 5886.421^f	18.860	19.020	10.340	5.880
Screen2 + HPV-4^d	159.397	30.880	6058.622^f	33.860	35.690	23.610	20.730
Screen2 + HPV-2^d	160.713	30.869	Dominated	32.280	32.280	6.460	19.790
Screen2 + HPV-9^d	168.002	30.881	6262.947^f	34.390	35.950	25.800	20.750
Screen3 ^{b, e}	34.004	30.865	1171.435^f 1171.435^f	18.540	18.860	8.010	4.100
Screen3 + HPV-4^e	110.341	30.878	5865.854^f	32.750	35.130	21.650	19.220
Screen3 + HPV-2^e	111.804	30.866	Dominated	31.170	31.720	3.890	18.280
Screen3 + HPV-9^e	118.927	30.879	6098.722^f	33.280	35.400	23.910	19.230

ICERs were calculated in 5 settings: ^ano intervention, HPV-4, HPV-2 and HPV-9; ^bno intervention, Screen3, Screen2 and Screen1; ^cno intervention, Screen1, Screen1 + HPV-4, Screen1 + HPV-2, and Screen1 + HPV-9; ^dno intervention, Screen2, Screen2 + HPV-4, Screen2 + HPV-2, and Screen2 + HPV-9; ^eno intervention, Screen3, Screen3 + HPV-4, Screen3 + HPV-2, and Screen3 + HPV-9
^fIf 0 < ICER < per capita GDP (7960 USD), it is considered very cost effective; ^gIf per capita GDP (7960 USD) < ICER <3 times of per capita GDP (23,880 USD), it is considered as cost effective; ^hIf ICER >3 times of per capita GDP (23,880 USD), it is considered not cost effective. Absolute dominated: An option is said to be dominated if it both costs more and is less effective than a comparator

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