ArticleJournal of health economics and outcomes research2026
Public Health Impact and Cost-Effectiveness of 2-Dose vs 1-Dose Human Papillomavirus Vaccination Regimen in Saudi Arabia.
Article in Journal of health economics and outcomes research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The Saudi Food and Drug Authority recently registered a 9-valent human papillomavirus (HPV) vaccine, which provides broader protection than the existing 4-valent vaccine against genital warts and various cancers. A single-dose protocol vs a 2-dose protocol has been considered as an option for girls aged 9 to 14 and 15 to 20 years in the Kingdom of Saudi Arabia (KSA). Objective: To assess cost-effectiveness and health outcomes associated with 2-dose vs 1-dose 9-valent HPV (9vHPV) vaccination in the KSA. Methods: A dynamic transmission model was used to assess public health impact and incremental cost-effectiveness ratio (ICER) of a 2-dose compared with a 1-dose 9vHPV program. Costs (2023 SAR) and quality-adjusted life-years (QALY) were discounted at 3%. Vaccination coverage was estimated using the Ministry of Health school-based program. Scenario analyses considered higher cervical cancer incidence and higher 1-dose vaccine effectiveness. Results: A 2-dose vs a 1-dose 9vHPV vaccine prevents 13 700 additional cases of HPV-related diseases over a time horizon of 100 years. Furthermore, the model yields an ICER of SAR 30 400/QALY gained. Under scenarios of higher cervical cancer incidence and higher 1-dose vaccine effectiveness, ICERs are SAR 17 400/QALY and SAR 83 200/QALY, respectively. For the scenario with higher cervical cancer incidence (ie, 6.1 per 100 000 women), the 2-dose program achieves cervical cancer elimination within a median time of 54 years, whereas the 1-dose program takes more than 100 years. In sensitivity analyses, the ICER remains below 1×GDP per capita (SAR 129 000). Conclusions: A 2-dose program shows a positive impact in terms of public health and cost-effectiveness compared with a 1-dose program.
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