Table 2 Mean cancer reduction and impact of the cost per vaccinated girl on the incremental cost-effectiveness ratios (I$/YLS) of cervical cancer prevention strategiesa

From: Health and economic impact of HPV 16 and 18 vaccination and cervical cancer screening in India

    Cost per vaccinated girl b
    I$10 I$20 I$30 I$50 I$75 I$360
   Mean cancer Approximate implied per dose cost
  Test reduction US$2 US$4 US$6 US$12 US$20 US$100
Table 2a . All strategies available         
Natural history (no screening or vaccination)   
Screening 1 time per lifetime at age 40 One-visit VIA 13% domc domc domc domc domc domc
  Two-visit HPV DNA 16% domc domc domc domc domc domc
Screening two times per lifetime at One-visit VIA 21% domc domc domc domc domc domc
ages 35 and 40 Two-visit HPV DNA 24% domc domc domc domc domc domc
  Three-visit cytology 21% domc domc domc domc domc domc
Screening three times per lifetime at One-visit VIA 29% domc I$60 I$60 I$60 I$60 I$60
ages 35, 40, and 45 Two-visit HPV DNA 33% domc domc domc domc domc domc
Vaccination   44% CS d domc domc domc domc domc
Vaccination+screening one time per One-visit VIA 52% domc domc domc domc domc domc
lifetime at age 40 Two-visit HPV DNA 53% domc domc domc domc domc domc
Vaccination+screening two times per One-visit VIA 56% domc domc domc domc domc domc
lifetime at ages 35 and 40 Two-visit HPV DNA 57% domc domc domc domc domc domc
  Three-visit cytology 56% domc domc domc domc domc domc
Vaccination+screening three times per One-visit VIA 61% I$290 I$340 I$630 I$1200 I$1920 I$7230
lifetime at ages 35, 40, and 45 Two-visit HPV DNA 63% I$82 540 I$82 540 I$82 540 I$82 540 I$82 540 I$82 540
Table 2b . Only two-visit HPV DNA testing available
Natural history   
Screening alone three times per lifetime    domc domc domc I$720 I$720 I$720
Vaccination    CS d I$190 I$390 I$890 domc domc
Vaccination+screening three times per lifetime    I$1780 I$1780 I$1780 I$1780 I$2030 I$7650
  1. After eliminating strategies that are dominated, incremental cost-effectiveness ratios are calculated for the remaining strategies and are expressed in I$2005 per YLS. The incremental cost-effectiveness ratios shown represent the mean costs divided by the mean effects of the good-fitting parameter sets.
  2. bCost per vaccinated girl includes three doses of vaccine, wastage, freight and supplies, administration, and immunisation support and programmatic costs.
  3. cdom: these strategies are either more costly and less effective, or less costly and less cost-effective, than alternative options, and are thus considered dominated.
  4. dCS: cost saving.
  5. HPV: human papillomavirus.
  6. VIA: visual inspection with acetic acid.