Cost-utility analysis of free HPV immunization for girls in Rajasthan, India

This peer-reviewed article presents a cost-utility analysis of introducing free Human Papillomavirus (HPV) vaccination for 11-year-old girls in Rajasthan, India. The study uses a static decision-analytic Markov model to estimate costs and quality-adjusted life years (QALYs) from the perspective of the Rajasthan state healthcare system, comparing a free vaccination program to the current scenario without HPV immunization in the state scheme.

Key findings and insights:

• Introducing free HPV vaccination for adolescent girls in Rajasthan is highly cost-effective and even cost-saving compared to no vaccination.
• The estimated incremental cost-effectiveness ratio (ICER) indicates cost savings per QALY gained, remaining favorable under multiple sensitivity analyses.
• The intervention remains cost-effective under willingness-to-pay thresholds based on one to three times the state’s per capita income.
• HPV vaccination has strong potential to reduce the burden of cervical cancer, which remains a significant public health and economic challenge in the state.
• A single-dose vaccination schedule could further improve feasibility and affordability in low-resource settings.
• The findings suggest that Rajasthan could serve as a scalable model for similar settings considering HPV vaccine introduction.

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