The Cost-Effectiveness of the Human Papilloma Virus Vaccination in Asia Pacific Countries: What Lessons Can Indonesia Learn?—A Systematic Review

<b>Background/Objectives:</b> Cervical cancer is a significant issue in Indonesia, with many cases diagnosed at advanced stages. Although the human papillomavirus (HPV) vaccination has long been recommended by the WHO, it was only recently included in Indonesia’s immunization program in...

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Main Authors: Suzanna Patricia Mongan, Joshua Byrnes, Hansoo Kim
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Vaccines
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Online Access:https://www.mdpi.com/2076-393X/13/6/593
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author Suzanna Patricia Mongan
Joshua Byrnes
Hansoo Kim
author_facet Suzanna Patricia Mongan
Joshua Byrnes
Hansoo Kim
author_sort Suzanna Patricia Mongan
collection DOAJ
description <b>Background/Objectives:</b> Cervical cancer is a significant issue in Indonesia, with many cases diagnosed at advanced stages. Although the human papillomavirus (HPV) vaccination has long been recommended by the WHO, it was only recently included in Indonesia’s immunization program in 2023. This study aimed to examine the existing prevention strategies and their effectiveness through systematic review of the existing literature. <b>Methods</b>: We searched for cost-effectiveness studies of HPV vaccination in Asia Pacific countries from inception until 23 July 2023, using MEDLINE, Embase, and the Cochrane Library databases. The search strategy included keywords and subject terms for primary prevention, HPV vaccination, cervical cancer, and selected Asia Pacific Countries (Thailand, Vietnam, China, Singapore, Malaysia, Philippines, Korea, Japan, Taiwan, Australia, New Zealand, and Hong Kong). Studies selected were limited to original research articles with full text published in English in peer-reviewed journals, describing the cost-effectiveness of HPV vaccination in cervical cancer prevention in the Asia Pacific countries. Studies were excluded if there were no full text was available, if it was the wrong study design, non-English, or not based in the specific Asia Pacific countries selected. The titles and abstracts were screened, followed by full-text reviews using Covidence software, and analyzed using Excel. <b>Results</b>: Forty-three studies were included for review: 51% in high-income countries (HICs), 37% in upper-middle-income countries (UMICs), and 12% in low-middle-income countries (LMICs). All studies concluded that HPV vaccination is more cost-effective than screening alone. Nonavalent HPV vaccines were more cost-effective in HICs (80%), bivalent vaccines were more cost-effective in UMICs (66%), and gender-neutral vaccination was cost-effective compared to screening in all studies conducted. <b>Conclusions</b>: HPV vaccination is a cost-effective prevention strategy for cervical cancer across all resource settings, offering greater value compared to screening alone. Selecting the most economically viable vaccine type and expanding to gender-neutral vaccination could enhance early prevention efforts. These findings offer guidance for Indonesia in designing evidence-based HPV vaccination policies as a part of national cancer control efforts. Further investigation is necessary to determine the optimal strategy for HPV vaccination in Indonesia.
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spelling doaj-art-159c2942278648aead4e4f9e3c63be6b2025-08-20T03:29:48ZengMDPI AGVaccines2076-393X2025-05-0113659310.3390/vaccines13060593The Cost-Effectiveness of the Human Papilloma Virus Vaccination in Asia Pacific Countries: What Lessons Can Indonesia Learn?—A Systematic ReviewSuzanna Patricia Mongan0Joshua Byrnes1Hansoo Kim2School of Medicine and Dentistry, Griffith University, Gold Coast, QLD 4222, AustraliaSchool of Medicine and Dentistry, Griffith University, Gold Coast, QLD 4222, AustraliaSchool of Medicine and Dentistry, Griffith University, Gold Coast, QLD 4222, Australia<b>Background/Objectives:</b> Cervical cancer is a significant issue in Indonesia, with many cases diagnosed at advanced stages. Although the human papillomavirus (HPV) vaccination has long been recommended by the WHO, it was only recently included in Indonesia’s immunization program in 2023. This study aimed to examine the existing prevention strategies and their effectiveness through systematic review of the existing literature. <b>Methods</b>: We searched for cost-effectiveness studies of HPV vaccination in Asia Pacific countries from inception until 23 July 2023, using MEDLINE, Embase, and the Cochrane Library databases. The search strategy included keywords and subject terms for primary prevention, HPV vaccination, cervical cancer, and selected Asia Pacific Countries (Thailand, Vietnam, China, Singapore, Malaysia, Philippines, Korea, Japan, Taiwan, Australia, New Zealand, and Hong Kong). Studies selected were limited to original research articles with full text published in English in peer-reviewed journals, describing the cost-effectiveness of HPV vaccination in cervical cancer prevention in the Asia Pacific countries. Studies were excluded if there were no full text was available, if it was the wrong study design, non-English, or not based in the specific Asia Pacific countries selected. The titles and abstracts were screened, followed by full-text reviews using Covidence software, and analyzed using Excel. <b>Results</b>: Forty-three studies were included for review: 51% in high-income countries (HICs), 37% in upper-middle-income countries (UMICs), and 12% in low-middle-income countries (LMICs). All studies concluded that HPV vaccination is more cost-effective than screening alone. Nonavalent HPV vaccines were more cost-effective in HICs (80%), bivalent vaccines were more cost-effective in UMICs (66%), and gender-neutral vaccination was cost-effective compared to screening in all studies conducted. <b>Conclusions</b>: HPV vaccination is a cost-effective prevention strategy for cervical cancer across all resource settings, offering greater value compared to screening alone. Selecting the most economically viable vaccine type and expanding to gender-neutral vaccination could enhance early prevention efforts. These findings offer guidance for Indonesia in designing evidence-based HPV vaccination policies as a part of national cancer control efforts. Further investigation is necessary to determine the optimal strategy for HPV vaccination in Indonesia.https://www.mdpi.com/2076-393X/13/6/593cervical cancerhuman papillomavirus vaccinationcost-effectivenessAsia PacificIndonesia
spellingShingle Suzanna Patricia Mongan
Joshua Byrnes
Hansoo Kim
The Cost-Effectiveness of the Human Papilloma Virus Vaccination in Asia Pacific Countries: What Lessons Can Indonesia Learn?—A Systematic Review
Vaccines
cervical cancer
human papillomavirus vaccination
cost-effectiveness
Asia Pacific
Indonesia
title The Cost-Effectiveness of the Human Papilloma Virus Vaccination in Asia Pacific Countries: What Lessons Can Indonesia Learn?—A Systematic Review
title_full The Cost-Effectiveness of the Human Papilloma Virus Vaccination in Asia Pacific Countries: What Lessons Can Indonesia Learn?—A Systematic Review
title_fullStr The Cost-Effectiveness of the Human Papilloma Virus Vaccination in Asia Pacific Countries: What Lessons Can Indonesia Learn?—A Systematic Review
title_full_unstemmed The Cost-Effectiveness of the Human Papilloma Virus Vaccination in Asia Pacific Countries: What Lessons Can Indonesia Learn?—A Systematic Review
title_short The Cost-Effectiveness of the Human Papilloma Virus Vaccination in Asia Pacific Countries: What Lessons Can Indonesia Learn?—A Systematic Review
title_sort cost effectiveness of the human papilloma virus vaccination in asia pacific countries what lessons can indonesia learn a systematic review
topic cervical cancer
human papillomavirus vaccination
cost-effectiveness
Asia Pacific
Indonesia
url https://www.mdpi.com/2076-393X/13/6/593
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