The health economics evaluation of HPV vaccine with different immunization strategies in Zhejiang Province based on the PRIME tool

Objective: To evaluate the health economics of human papillomavirus (HPV) vaccination for school-age female children in Zhejiang Province under different immunization regimens. Methods: The PRIME tool recommended by the World Health Organization (WHO) was used to evaluate the health economics of HPV vaccination by modifying and replacing local data with custom parameters, and the results of sensitivity analysis and economics were combined to select the optimal immunization strategy. Results: Assuming a free HPV vaccination program among all school-age female children (13 years old) in Zhejiang Province from 2022, the net annual costs to be invested in the scenario of using domestic bivalent and imported bivalent, imported quadrivalent, and ninevalent HPV vaccines to carry out immunization in the province with a full vaccination coverage of 80% of the target vaccination population and a discount rate of 3% are 153 million, 433 million, 597 million, and 967 million, respectively. For each disability-adjusted life year (DALY) saved due to cervical cancer, the incremental costs (CER) were 34,700, 97,800, 135,000, and 170,300 Yuan for different HPV vaccines, respectively, compared with no intervention program. The incremental cost effectiveness ratios (ICER)/annual GDP per capita ratio is 0.31, 0.87, 1.19, and 1.51 for different HPV vaccines. The recommended solution is to apply domestic bivalent vaccine, discount 80% of vaccine procurement cost, and achieve 90% coverage of full vaccination. Conclusion: The immunization strategy for children of school-age females using the domestically produced bivalent HPV vaccine in Zhejiang Province has a highly favorable performance in terms of health economics.