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Table 1 Model input parameters

From: Cost-effectiveness of Human Papilloma Virus (HPV) vaccination in Nigeria: a decision analysis using pragmatic parameter estimates for cost and programme coverage

Parameters

Base Case [min – max], (α, β)

Distributions

Reference

Demographic & Clinical Parameters

 Rural population (%)

53%

–

[17]

 Urban population (%)

47%

–

[17]

Vaccine and screening coverage and outcomes

 Vaccine efficacy for HPV 16/18

0.9 (124, 13.8)

Beta

[38]

 HPV 16/18 prevalence in CC

66.9% (58.9% – 74.0%)

Triangular

[1]

 Vaccine efficacy for 10 other HPV oncogenic types

0.302 (6.06, 14.02]

Beta

[39]

 10 other HPV oncogenic type prevalence in CC

32.0% (14.9% – 72.9%)

Triangular

[1]

 Assumed vaccine coveragea

66% [66% -70%]

Triangular

[40]

 VIA sensitivity

70.8% [60% - 76%]

Triangular

[41,42,43]

 Opportunistic screening coverage

8.7%

–

[1]

 Assumed achievable screening coverageb

20%

–

[12]

Transition Probabilities

 

1 yr

99 yrs

  

 Age specific mortality rate

0.0098

0.3165

Table

[44]

 

10 yrs

99 yrs

  

 Normal → HPV

0.14

0.00

Table

[9, 45]

 HPV → CIN 1

0.05

–

[46]

 CIN1 → CIN2/3

0.09

–

[47,48,49]

 CIN2/3 → persistent CIN2/3

0.11

–

[48, 49]

 

10 yrs

80 yrs

  

 HPV → Normal

0.29

0.55

Table

[46, 48,49,50]

 CIN1 → Normal

0.45

–

[47,48,49, 51, 52]

 CIN2/3 → Normal

0.23

–

[47,48,49, 51, 52]

 Persistent CIN2/3 → Cancer

0.0–0.10

Uniform

[9]

 Cancer → Cancer cured

0.084

–

[9]

Disability Weights

 Disability weight of cervical cancer state

0.08 [0.0–0.9]

Triangular

[29, 53]

 Disability weight of death state

1

–

[29]

 Disability weight of asymptomatic states

0

–

[29]

Cost data

 CVG at $13 per dose (urban/rural)

$35.16/$36.26

–

[24]

 CVG at $11 per dose (urban/rural)

$31.16/$32.26

–

[24]

 CVG at $9 per dose (urban/rural)

$27.16/$28.26

–

[24]

 CVG at $7 per dose (urban/rural)

$23.16/$24.26

-

[24]

 CVG at $5 per dose (urban/rural)

$19.16/$20.26

-

 

 CVG at $4.5 per dose (urban/rural)

$18.16/$19.26

–

[24]

 Lifetime CC treatment cost

$1635.96

–

[9]

 Screening cost (VIA)

$6.12 [3.95–25.26]

Triangular

[54]

 Cryotherapy cost

$27.96 [14.57–337.68]

Triangular

[54]

  1. CVG cost per fully vaccinated girl, VIA visual inspection with acetic acid, CIN cervical intraepithelial neoplasia, CC cervical cancer
  2. aCoverage of 2nd dose of diphtheria toxoid, tetanus toxoid and pertussis vaccine (DTP2) used as a proxy to assess Nigeria’s capacity to introduce and implement the HPV vaccines
  3. bCoverage of cervical cancer screening based on coverage rate achieved by South Africa
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