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Setiawan D, Annisa AN, Lianawati, Hutubessy RCW, Ting Yeung KH. The Cost Analysis of Human Papillomavirus Vaccination Program in Indonesia. Value Health Reg Issues 2023; 35:102-108. [PMID: 36934486 DOI: 10.1016/j.vhri.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 12/05/2022] [Accepted: 01/20/2023] [Indexed: 03/19/2023]
Abstract
OBJECTIVES This study aimed to analyze and describe the cost of HPV vaccination program in Indonesia. METHODS This study identified the cost-related HPV vaccination program implemented in Makassar, Manado, and Surabaya cities, Indonesia, according to the previous activities performed. Cost information was collected and analyzed in each specific activity for each cost components, using the HPV vaccination module of the World Health Organization Cervical Cancer Prevention and Control Costing tool. RESULTS According to the Cervical Cancer Prevention and Control Costing tool, the recurrent costs, both financial and economic costs, dominated the HPV vaccination program costs in Surabaya (US dollars [USD] 264 618; USD 268 724), Makassar (USD 166 852; USD 293 300), and Manado (USD 270 815; USD 270 946), with a total cost of USD 702 285 for financial cost and USD 832 970 for economic cost. Vaccine procurement drives the recurrent cost. CONCLUSIONS The implementation of demonstration program in Surabaya, Makassar, and Manado cities was considerably succeed. Any prediction related to the cost of implementation of HPV vaccination in Indonesia can be calculated and used to advocate regional or national government.
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Affiliation(s)
- Didik Setiawan
- Faculty of Pharmacy, Universitas Muhammadiyah Purwokerto, Purwokerto, Central of Java, Indonesia; Center for Health Economics Studies, Universitas Muhammadiyah Purwokerto, Purwokerto, Central of Java, Indonesia.
| | - Andi Nurul Annisa
- Center for Health Economics Studies, Universitas Muhammadiyah Purwokerto, Purwokerto, Central of Java, Indonesia
| | - Lianawati
- Center for Health Economics Studies, Universitas Muhammadiyah Purwokerto, Purwokerto, Central of Java, Indonesia
| | - Raymond C W Hutubessy
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Switzerland
| | - Karene Hoi Ting Yeung
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Switzerland
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Beyer K, Kasasa S, Anguzu R, Lukande R, Nambooze S, Amulen PM, Zhou Y, Nansereko B, Jankowski C, Oyana T, Savino D, Feustel K, Wabinga H. High-resolution disease maps for cancer control in low-resource settings: A spatial analysis of cervical cancer incidence in Kampala, Uganda. J Glob Health 2022; 12:04032. [PMID: 35493778 PMCID: PMC9022722 DOI: 10.7189/jogh.12.04032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background The global burden of cervical cancer is concentrated in low-and middle-income countries (LMICs), with the greatest burden in Africa. Targeting limited resources to populations with the greatest need to maximize impact is essential. The objectives of this study were to geocode cervical cancer data from a population-based cancer registry in Kampala, Uganda, to create high-resolution disease maps for cervical cancer prevention and control planning, and to share lessons learned to optimize efforts in other low-resource settings. Methods Kampala Cancer Registry records for cervical cancer diagnoses between 2008 and 2015 were updated to include geographies of residence at diagnosis. Population data by age and sex for 2014 was obtained from the Uganda Bureau of Statistics. Indirectly age-standardized incidence ratios were calculated for sub-counties and estimated continuously across the study area using parish level data. Results Overall, among 1873 records, 89.6% included a valid sub-county and 89.2% included a valid parish name. Maps revealed specific areas of high cervical cancer incidence in the region, with significant variation within sub-counties, highlighting the importance of high-resolution spatial detail. Conclusions Population-based cancer registry data and geospatial mapping can be used in low-resource settings to support cancer prevention and control efforts, and to create the potential for research examining geographic factors that influence cancer outcomes. It is essential to support LMIC cancer registries to maximize the benefits from the use of limited cancer control resources.
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Affiliation(s)
- Kirsten Beyer
- Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | | | - Ronald Anguzu
- Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Robert Lukande
- Makerere University, Kampala, Uganda
- Kampala Cancer Registry, Kampala, Uganda
| | - Sarah Nambooze
- Makerere University, Kampala, Uganda
- Kampala Cancer Registry, Kampala, Uganda
| | - Phoebe M Amulen
- Makerere University, Kampala, Uganda
- Kampala Cancer Registry, Kampala, Uganda
| | - Yuhong Zhou
- Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | | | | | | | | | | | - Henry Wabinga
- Makerere University, Kampala, Uganda
- Kampala Cancer Registry, Kampala, Uganda
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Cox SN, Wedlock PT, Pallas SW, Mitgang EA, Yemeke TT, Bartsch SM, Abimbola T, Sigemund SS, Wallace A, Ozawa S, Lee BY. A systems map of the economic considerations for vaccination: Application to hard-to-reach populations. Vaccine 2021; 39:6796-6804. [PMID: 34045101 PMCID: PMC8889938 DOI: 10.1016/j.vaccine.2021.05.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 05/06/2021] [Accepted: 05/11/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Understanding the economics of vaccination is essential to developing immunization strategies that can be employed successfully with limited resources, especially when vaccinating populations that are hard-to-reach. METHODS Based on the input from interviews with 24 global experts on immunization economics, we developed a systems map of the mechanisms (i.e., necessary steps or components) involved in vaccination, and associated costs and benefits, focused at the service delivery level. We used this to identify the mechanisms that may be different for hard-to-reach populations. RESULTS The systems map shows different mechanisms that determine whether a person may or may not get vaccinated and the potential health and economic impacts of doing so. The map is divided into two parts: 1) the costs of vaccination, representing each of the mechanisms involved in getting vaccinated (n = 23 vaccination mechanisms), their associated direct vaccination costs (n = 18 vaccination costs), and opportunity costs (n = 5 opportunity costs), 2) the impact of vaccination, representing mechanisms after vaccine delivery (n = 13 impact mechanisms), their associated health effects (n = 10 health effects for beneficiary and others), and economic benefits (n = 13 immediate and secondary economic benefits and costs). Mechanisms that, when interrupted or delayed, can result in populations becoming hard-to-reach include getting vaccines and key stakeholders (e.g., beneficiaries/caregivers, vaccinators) to a vaccination site, as well as vaccine administration at the site. CONCLUSION Decision-makers can use this systems map to understand where steps in the vaccination process may be interrupted or weak and identify where gaps exist in the understanding of the economics of vaccination. With improved understanding of system-wide effects, this map can help decision-makers inform targeted interventions and policies to increase vaccination coverage in hard-to-reach populations.
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Affiliation(s)
- Sarah N Cox
- Public Health Informatics, Computational, and Operations Research (PHICOR), City University of New York (CUNY) Graduate School of Public Health and Health Policy, New York City, NY, United States
| | - Patrick T Wedlock
- Public Health Informatics, Computational, and Operations Research (PHICOR), City University of New York (CUNY) Graduate School of Public Health and Health Policy, New York City, NY, United States
| | - Sarah W Pallas
- Global Immunization Division, Centers for Disease Control and Prevention (CDC), Atlanta, GA, United States
| | - Elizabeth A Mitgang
- Public Health Informatics, Computational, and Operations Research (PHICOR), City University of New York (CUNY) Graduate School of Public Health and Health Policy, New York City, NY, United States
| | - Tatenda T Yemeke
- Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, United States
| | - Sarah M Bartsch
- Public Health Informatics, Computational, and Operations Research (PHICOR), City University of New York (CUNY) Graduate School of Public Health and Health Policy, New York City, NY, United States
| | - Taiwo Abimbola
- Global Immunization Division, Centers for Disease Control and Prevention (CDC), Atlanta, GA, United States
| | - Sheryl S Sigemund
- Public Health Informatics, Computational, and Operations Research (PHICOR), City University of New York (CUNY) Graduate School of Public Health and Health Policy, New York City, NY, United States
| | - Aaron Wallace
- Global Immunization Division, Centers for Disease Control and Prevention (CDC), Atlanta, GA, United States
| | - Sachiko Ozawa
- Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, United States; Department of Maternal and Child Health, UNC Gillings School of Global Health, University of North Carolina, Chapel Hill, NC, United States
| | - Bruce Y Lee
- Public Health Informatics, Computational, and Operations Research (PHICOR), City University of New York (CUNY) Graduate School of Public Health and Health Policy, New York City, NY, United States.
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Ferguson MC, Morgan MJ, O’Shea KJ, Winch L, Siegmund SS, Gonzales MS, Randall S, Hertenstein D, Montague V, Woodberry A, Cassatt T, Lee BY. Using Simulation Modeling to Guide the Design of the Girl Scouts Fierce & Fit Program. Obesity (Silver Spring) 2020; 28:1317-1324. [PMID: 32378341 PMCID: PMC7311310 DOI: 10.1002/oby.22827] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 03/07/2020] [Accepted: 03/28/2020] [Indexed: 01/29/2023]
Abstract
OBJECTIVE The study aim was to help the Girl Scouts of Central Maryland evaluate, quantify, and potentially modify the Girl Scouts Fierce & Fit program. METHODS From 2018 to 2019, our Public Health Informatics, Computational, and Operations Research team developed a computational simulation model representing the 250 adolescent girls participating in the Fierce & Fit program and how their diets and physical activity affected their BMI and subsequent outcomes, including costs. RESULTS Changing the Fierce & Fit program from a 6-week program meeting twice a week, with 5 minutes of physical activity each session, to a 12-week program meeting twice a week with 30 minutes of physical activity saved an additional $84,828 ($80,130-$89,526) in lifetime direct medical costs, $81,365 ($76,528-$86,184) in lifetime productivity losses, and 7.85 (7.38-8.31) quality-adjusted life-years. The cost-benefit of implementing this program was $95,943. Based on these results, the Girl Scouts of Central Maryland then implemented these changes in the program. CONCLUSIONS This is an example of using computational modeling to help evaluate and revise the design of a program aimed at increasing physical activity among girls.
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Affiliation(s)
- Marie C. Ferguson
- PHICOR (Public Health Informatics, Computational and Operations Research), City University of New York Graduate School of Public Health and Health Policy, New York, New York, (formerly at Johns Hopkins University, Baltimore, MD)
| | - Matthew J. Morgan
- PHICOR (Public Health Informatics, Computational and Operations Research), City University of New York Graduate School of Public Health and Health Policy, New York, New York, (formerly at Johns Hopkins University, Baltimore, MD)
| | - Kelly J. O’Shea
- PHICOR (Public Health Informatics, Computational and Operations Research), City University of New York Graduate School of Public Health and Health Policy, New York, New York, (formerly at Johns Hopkins University, Baltimore, MD)
| | - Lucas Winch
- PHICOR (Public Health Informatics, Computational and Operations Research), City University of New York Graduate School of Public Health and Health Policy, New York, New York, (formerly at Johns Hopkins University, Baltimore, MD)
| | - Sheryl S. Siegmund
- PHICOR (Public Health Informatics, Computational and Operations Research), City University of New York Graduate School of Public Health and Health Policy, New York, New York, (formerly at Johns Hopkins University, Baltimore, MD)
| | - Mario Solano Gonzales
- PHICOR (Public Health Informatics, Computational and Operations Research), City University of New York Graduate School of Public Health and Health Policy, New York, New York, (formerly at Johns Hopkins University, Baltimore, MD)
| | - Samuel Randall
- PHICOR (Public Health Informatics, Computational and Operations Research), City University of New York Graduate School of Public Health and Health Policy, New York, New York, (formerly at Johns Hopkins University, Baltimore, MD)
| | - Daniel Hertenstein
- PHICOR (Public Health Informatics, Computational and Operations Research), City University of New York Graduate School of Public Health and Health Policy, New York, New York, (formerly at Johns Hopkins University, Baltimore, MD)
| | | | | | | | - Bruce Y. Lee
- PHICOR (Public Health Informatics, Computational and Operations Research), City University of New York Graduate School of Public Health and Health Policy, New York, New York, (formerly at Johns Hopkins University, Baltimore, MD)
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