Türkiye could reap large health gains at good value by adding HPV vaccination to its national schedule, according to a new cost-effectiveness analysis in BMC Public Health. Using WHO’s PRIME model, researchers compared two strategies for 12-year-old girls—bivalent/quadrivalent (Scenario 1) and nonavalent (Scenario 2)—and found ICERs of US$2,231 and US$2,342 per DALY averted, respectively. Both options were “very cost-effective” against standard thresholds, with results most sensitive to the discount rate, followed by vaccine efficacy, HPV type distribution, and price. After accounting for savings from treatment averted and applying a 3% discount rate, the net program costs were US$14.3 million for Scenario 1 and US$21.7 million for Scenario 2.
From the payer perspective, introducing HPV vaccination would raise Türkiye’s annual vaccine budget by an estimated 5–8%, while preventing future cervical cancer cases and deaths; threshold analyses suggest programs remain highly cost-effective well below GDP per capita. The study strengthens the economic case for immediate adoption—especially if paired with screening—and provides price-sensitivity insights relevant to procurement decisions and to other MICs weighing vaccine choice (bivalent/quadrivalent vs 9-valent).
How can the findings be used?
These findings can inform the Ministry of Health’s immunization and cervical cancer control policies by quantifying budget impact and value for money under realistic price and coverage assumptions. Procurement and tender committees can use the price-sensitivity and threshold analyses to negotiate vaccine prices and choose between bivalent/quadrivalent and 9-valent options. Screening program leads can leverage the results to integrate HPV vaccination with screening for a combined, more cost-effective strategy. Finally, global and regional partners/donors and other middle-income countries can adapt the parameterization as a template for their own assessments.
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