A modeling analysis from Merck & Co evaluated the public health impact and cost-effectiveness of implementing a 1-dose or a 2-dose program of the 9-valent HPV vaccine in a low- and middle-income country (LMIC), adopting a dynamic transmission model to the Indonesia setting.
The scenarios tested included different coverage levels targeted at girls-only, or girls and boys. Costs and benefits were computed over 100 years from a national single-payer perspective.
Depending on the coverage and target population, the median number of cancer cases avoided in 2-dose programs ranged between 600,000–2,100,000, compared to 200,000–600,000 in 1-dose programs. The 1-dose programs are unlikely to be cost-effective compared to 2-dose programs even at low willingness-to-pay thresholds.
The findings showed that adoption of 1-dose programs with 9-valent vaccine in an LMIC resulted in more vaccine-preventable HPV-related cancer cases than 2-dose programs. The 2-dose programs were more likely to be cost-effective than 1-dose programs for a wide range of willingness-to-pay thresholds and scenarios.
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