Cervical cancer prevention in Morocco : a model-based cost-effectiveness analysis

Cervical cancer is a preventable disease. Despite this, the annual incidence globally is projected to increase from 570,000 cases currently to 700,000 by 2030, and most of these will be among young under-educated women in low- and middle-income countries (LMICs) (1, 2). The human papillomavirus (HPV) vaccine offers the potential to eliminate cervical cancer if routinely available and used based on recent studies (3). This is especially important in LMICs where the cost of cancer care can be prohibitive including biological medicines (4). It is for this reason that the recent study of Messoudi et al (2019) assessing the cost-effectiveness of the HPV vaccine in Morocco is both necessary and impactful to guide future healthcare funding strategies across Africa and wider. As a result, help achieve the WHO goal of eliminating cervical cancer as a public health problem (1, 2). The authors successfully developed a Markov model to determine the cost/ life year saved (LYS) from the HPV vaccination programme versus traditional screening approaches, or combined approaches, based on a previous model from Spain and subsequently calibrated with data from Morocco including current incidence figures. Annual transition probabilities with respect to the natural history of HPV infections and cervical cancer were taken from published studies on the assumption that the natural history would not differ between countries (2). This appears a reasonable assumption along with the cost of the vaccine based on the negotiated price of the Revolving Fund of the WHO Pan American Health Organisation (2). The price could even be lower based on current estimates of the manufacturing costs.

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