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Table 6 Scenario results: HIV+ subpopulation

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

Outcomes

Screening

Screening + HPV vaccination

Incremental value

ICER (ZAR/QALY)

NO DISCOUNTING

Total costs

ZAR 295 251 951

ZAR 248 833 762

ZAR −46 418 189

 

Vaccine cost

ZAR 0

ZAR 183 228 152

ZAR 183 228 152

 

Screening cost

ZAR 19 794 328

ZAR 21 262 010

ZAR 1 467 682

 

CIN1 treatment cost

ZAR 3 641 306

ZAR 557 658

ZAR −3 083 648

 

CIN2/3 treatment cost

ZAR 3 545 580

ZAR 561 971

ZAR −2 983 609

 

CC treatment cost

ZAR 268 270 736

ZAR 43 223 970

ZAR −225 046 766

 

Life years

3 179 736

3 186 707

6 971

 

CC cases

2 161

348

−1 813

 

CC cancer deaths

2 035

328

−1 707

 

QALYs

2 573 677

2 580 925

7 248

V + S dominant

DISCOUNTED AT 5 %

Total costs

ZAR 62 169 185

ZAR 198 527 858

ZAR 136 358 673

 

Vaccine cost

ZAR 0

ZAR 183 228 152

ZAR 183 228 152

 

Screening cost

ZAR 5 766 054

ZAR 6 223 334

ZAR 457 279

 

CIN1 treatment cost

ZAR 1 126 206

ZAR 177 452

ZAR −948 755

 

CIN2/3 treatment cost

ZAR 1 183 601

ZAR 190 676

ZAR −992 925

 

CC treatment cost

ZAR 54 093 324

ZAR 8 708 245

ZAR −45 385 079

 

Life years

1 283 817

1 285 076

1 259

 

QALYs

1 039 522

1 040 852

1 331

ZAR 102 479

  1. 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