ArticleBMC public health2011
Cost-effectiveness of different human papillomavirus vaccines in Singapore.
Article in BMC public health, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 44 citations in OpenAlex.
- The cost-effectiveness of bivalent, quadrivalent, and nine-valent HPV vaccination in Asia: a systematic review.Archives of gynecology and obstetrics · 2022Pooled it
- Cost-effectiveness analysis of different types of human papillomavirus vaccination to prevent cervical cancer in Iran.BMC public health · 2025Article
- Review
- HPV Vaccination Program in Indonesia: Effectiveness, Dose, Scale-Up Costs, Future Prospects, and Policy Recommendations.Asian Pacific journal of cancer prevention : APJCP · 2025Article
- Cost-Effectiveness of Bivalent, Quadrivalent, and Nonavalent HPV Vaccination in South Africa.Clinical drug investigation · 2022Article
- Cervical cancer prevention in Indonesia: An updated clinical impact, cost-effectiveness and budget impact analysis.PloS one · 2020Article
- Cost-effectiveness of two-dose human papillomavirus vaccination in Singapore.Singapore medical journal · 2018Article
- Comparative Cost-Effectiveness Analysis of Two Different Two-Dose Human Papillomavirus Vaccines in MalaysiaAsian Pacific journal of cancer prevention : APJCP · 2018Article
- Cost-effectiveness analysis of different types of human papillomavirus vaccination combined with a cervical cancer screening program in mainland China.BMC infectious diseases · 2017Article
- Knowledge, attitudes and practices regarding human papillomavirus vaccination among young women attending a tertiary institution in Singapore.Singapore medical journal · 2016Article
- Assessment of the Broader Economic Consequences of HPV Prevention from a Government-Perspective: A Fiscal Analytic Approach.PloS one · 2016Article
- Applying a Simple Model of Cost Effectiveness Study of HPV Vaccine for Iran.Iranian journal of pharmaceutical research : IJPR · 2015Article
- Cost-effectiveness analysis of the bivalent and quadrivalent human papillomavirus vaccines from a societal perspective in Colombia.PloS one · 2013Article
- Modeling preventative strategies against human papillomavirus-related disease in developed countries.Vaccine · 2012Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHuman papillomavirus (HPV) vaccines are widely available and there have been studies exploring their potential clinical impact and cost-effectiveness. However, few studies have compared the cost-effectiveness among the 2 main vaccines available - a bivalent vaccine against HPV 16/18, and a quadrivalent vaccine against 6/11/16/18. We explore the cost-effectiveness of these two HPV vaccines in tropical Singapore.
methodsWe developed a Markov state-transition model to represent the natural history of cervical cancer to predict HPV infection, cancer incidence, mortality, and costs. Cytologic screening and treatment of different outcomes of HPV infection were incorporated. Vaccination was provided to a cohort of 12-year old females in Singapore, followed up until death. Based on available vaccines on the market, the bivalent vaccine had increased effectiveness against a wider range of HPV types, while the quadrivalent vaccine had effectiveness against genital warts. Incremental cost-effectiveness ratios (ICER) compared vaccination to no-vaccination, and between the two vaccines. Sensitivity analyses explored differences in vaccine effectiveness and uptake, and other key input parameters.
resultsFor the no vaccination scenario, 229 cervical cancer cases occurred over the cohort's lifetime. The total discounted cost per individual due to HPV infection was SGD$275 with 28.54 discounted life-years. With 100% vaccine coverage, the quadrivalent vaccine reduced cancers by 176, and had an ICER of SGD$12,866 per life-year saved. For the bivalent vaccine, 197 cancers were prevented with an ICER of $12,827 per life-year saved. Comparing the bivalent to the quadrivalent vaccine, the ICER was $12,488 per life-year saved. However, the cost per QALY saved for the quadrivalent vaccine compared to no vaccine was $9,071, while it was $10,392 for the bivalent vaccine, with the quadrivalent vaccine dominating the bivalent vaccine due to the additional QALY effect from reduction in genital warts. The overall outcomes were most sensitive to vaccine cost and coverage.
conclusionHPV vaccination is a cost-effective strategy, and should be considered a possible strategy to reduce the impact of HPV infection.
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