Economic Evaluation of Cervical Cancer Screening by HPV DNA, VIA, and Pap smear Methods in Indonesia
Cervical cancer occurs 80% in developing country including Indonesia and take place in the first rank of incidence rate and third rank in mortality rate in Asian Pacific. Natural history of cervical cancer gives a potential to get accurate screening method. Cervical cancer screening m in Indonesia u...
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| Veröffentlicht in: | Asian Pacific Journal of Cancer Prevention 2024-09, Vol.25 (9), p.3015-3022 |
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| creator | Hafidz, Firdaus Icanervilia, Ajeng Viska Rizal, Muhammad Fikru Listiani, Putri Setyaningsih, Hermawati Sasanti, Maria Lastri Ekawati, Fitriana Murriya Atthobari, Jarir At Utami, Tofan Widya Trirahmanto, Addin Tjokroprawiro, Brahmana Askandar Harsono, Ali Budi Masytoh, Lusiana Siti Haryani, Windi Subekti, Yusuf Nadjib, Mardiati |
| description | Cervical cancer occurs 80% in developing country including Indonesia and take place in the first rank of incidence rate and third rank in mortality rate in Asian Pacific. Natural history of cervical cancer gives a potential to get accurate screening method. Cervical cancer screening m in Indonesia use VIA and Pap smear method for women in age range 30 to 50 years old. Recently, HPV DNA test has been recommended in international and national policy as primary screening method for cervical cancer. This research aims to asses cost-effectiveness and economic implications of specific cervical cancer screening modalities.
Cost-effectiveness analysis was conducted from societal perspective. Cost data was collected from four hospitals in Indonesia. Direct medical costs were derived from discussions with an expert panel and hospital billing data, aligning with current practice guidelines. Direct and indirect non-medical costs were estimated from patient interviews. Effectiveness data for the screening methods were extracted from a systematic review of existing literature. Markov model design was used for cost-effectiveness analysis. Budget impact analysis used healthcare perspective method from its billing for cervical cancer patients.
Cervical cancer screening costs are calculated using direct medical, non-medical, and indirect expenses. Regarding to cost-effective analysis by incremental cost-effective ratio (ICER), pap smear for every 3 and 5 years is more cost-effective than VIA. HPV DNA also has the potential to be cost-effective. The budget impact analysis investigates scenarios, with a focus on negotiation-based cost reductions for HPV DNA testing. Controlling HPV DNA tariffs at USD 8.76 proves cost-effective.
In conclusion, pap smear is the most cost-effective modality, while HPV DNA has the potential to be cost-effective by reducing the unit cost. Despite favorable outcomes, challenges in implementation suggest a phased approach for resource equalization before full deployment. |
| doi_str_mv | 10.31557/APJCP.2024.25.9.3015 |
| format | Article |
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Cost-effectiveness analysis was conducted from societal perspective. Cost data was collected from four hospitals in Indonesia. Direct medical costs were derived from discussions with an expert panel and hospital billing data, aligning with current practice guidelines. Direct and indirect non-medical costs were estimated from patient interviews. Effectiveness data for the screening methods were extracted from a systematic review of existing literature. Markov model design was used for cost-effectiveness analysis. Budget impact analysis used healthcare perspective method from its billing for cervical cancer patients.
Cervical cancer screening costs are calculated using direct medical, non-medical, and indirect expenses. Regarding to cost-effective analysis by incremental cost-effective ratio (ICER), pap smear for every 3 and 5 years is more cost-effective than VIA. HPV DNA also has the potential to be cost-effective. The budget impact analysis investigates scenarios, with a focus on negotiation-based cost reductions for HPV DNA testing. Controlling HPV DNA tariffs at USD 8.76 proves cost-effective.
In conclusion, pap smear is the most cost-effective modality, while HPV DNA has the potential to be cost-effective by reducing the unit cost. Despite favorable outcomes, challenges in implementation suggest a phased approach for resource equalization before full deployment.</description><identifier>ISSN: 2476-762X</identifier><identifier>ISSN: 1513-7368</identifier><identifier>EISSN: 2476-762X</identifier><identifier>DOI: 10.31557/APJCP.2024.25.9.3015</identifier><identifier>PMID: 39342578</identifier><language>eng</language><publisher>Thailand: West Asia Organization for Cancer Prevention</publisher><subject>Adult ; Cost-Benefit Analysis ; DNA, Viral - analysis ; DNA, Viral - genetics ; Early Detection of Cancer - economics ; Early Detection of Cancer - methods ; Female ; Follow-Up Studies ; Humans ; Indonesia - epidemiology ; Mass Screening - economics ; Mass Screening - methods ; Middle Aged ; Papanicolaou Test - economics ; Papillomaviridae - genetics ; Papillomaviridae - isolation & purification ; Papillomavirus Infections - diagnosis ; Papillomavirus Infections - economics ; Papillomavirus Infections - virology ; Prognosis ; Uterine Cervical Neoplasms - diagnosis ; Uterine Cervical Neoplasms - economics ; Uterine Cervical Neoplasms - virology ; Vaginal Smears - economics ; Vaginal Smears - methods</subject><ispartof>Asian Pacific Journal of Cancer Prevention, 2024-09, Vol.25 (9), p.3015-3022</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><orcidid>0000-0003-2906-8423 ; 0000-0001-8676-7525 ; 0000-0002-0064-3255 ; 0000-0002-2014-3784 ; 0000-0002-7035-4846 ; 0000-0003-1658-3477 ; 0000-0002-1428-9031 ; 0000-0002-3622-0510 ; 0000-0001-6342-321X ; 0000-0002-1787-4930</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11700344/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11700344/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27922,27923,53789,53791</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39342578$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hafidz, Firdaus</creatorcontrib><creatorcontrib>Icanervilia, Ajeng Viska</creatorcontrib><creatorcontrib>Rizal, Muhammad Fikru</creatorcontrib><creatorcontrib>Listiani, Putri</creatorcontrib><creatorcontrib>Setyaningsih, Hermawati</creatorcontrib><creatorcontrib>Sasanti, Maria Lastri</creatorcontrib><creatorcontrib>Ekawati, Fitriana Murriya</creatorcontrib><creatorcontrib>Atthobari, Jarir At</creatorcontrib><creatorcontrib>Utami, Tofan Widya</creatorcontrib><creatorcontrib>Trirahmanto, Addin</creatorcontrib><creatorcontrib>Tjokroprawiro, Brahmana Askandar</creatorcontrib><creatorcontrib>Harsono, Ali Budi</creatorcontrib><creatorcontrib>Masytoh, Lusiana Siti</creatorcontrib><creatorcontrib>Haryani, Windi</creatorcontrib><creatorcontrib>Subekti, Yusuf</creatorcontrib><creatorcontrib>Nadjib, Mardiati</creatorcontrib><title>Economic Evaluation of Cervical Cancer Screening by HPV DNA, VIA, and Pap smear Methods in Indonesia</title><title>Asian Pacific Journal of Cancer Prevention</title><addtitle>Asian Pac J Cancer Prev</addtitle><description>Cervical cancer occurs 80% in developing country including Indonesia and take place in the first rank of incidence rate and third rank in mortality rate in Asian Pacific. Natural history of cervical cancer gives a potential to get accurate screening method. Cervical cancer screening m in Indonesia use VIA and Pap smear method for women in age range 30 to 50 years old. Recently, HPV DNA test has been recommended in international and national policy as primary screening method for cervical cancer. This research aims to asses cost-effectiveness and economic implications of specific cervical cancer screening modalities.
Cost-effectiveness analysis was conducted from societal perspective. Cost data was collected from four hospitals in Indonesia. Direct medical costs were derived from discussions with an expert panel and hospital billing data, aligning with current practice guidelines. Direct and indirect non-medical costs were estimated from patient interviews. Effectiveness data for the screening methods were extracted from a systematic review of existing literature. Markov model design was used for cost-effectiveness analysis. Budget impact analysis used healthcare perspective method from its billing for cervical cancer patients.
Cervical cancer screening costs are calculated using direct medical, non-medical, and indirect expenses. Regarding to cost-effective analysis by incremental cost-effective ratio (ICER), pap smear for every 3 and 5 years is more cost-effective than VIA. HPV DNA also has the potential to be cost-effective. The budget impact analysis investigates scenarios, with a focus on negotiation-based cost reductions for HPV DNA testing. Controlling HPV DNA tariffs at USD 8.76 proves cost-effective.
In conclusion, pap smear is the most cost-effective modality, while HPV DNA has the potential to be cost-effective by reducing the unit cost. Despite favorable outcomes, challenges in implementation suggest a phased approach for resource equalization before full deployment.</description><subject>Adult</subject><subject>Cost-Benefit Analysis</subject><subject>DNA, Viral - analysis</subject><subject>DNA, Viral - genetics</subject><subject>Early Detection of Cancer - economics</subject><subject>Early Detection of Cancer - methods</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Indonesia - epidemiology</subject><subject>Mass Screening - economics</subject><subject>Mass Screening - methods</subject><subject>Middle Aged</subject><subject>Papanicolaou Test - economics</subject><subject>Papillomaviridae - genetics</subject><subject>Papillomaviridae - isolation & purification</subject><subject>Papillomavirus Infections - diagnosis</subject><subject>Papillomavirus Infections - economics</subject><subject>Papillomavirus Infections - virology</subject><subject>Prognosis</subject><subject>Uterine Cervical Neoplasms - diagnosis</subject><subject>Uterine Cervical Neoplasms - economics</subject><subject>Uterine Cervical Neoplasms - virology</subject><subject>Vaginal Smears - economics</subject><subject>Vaginal Smears - methods</subject><issn>2476-762X</issn><issn>1513-7368</issn><issn>2476-762X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkNtOAjEQhhujEUQfQdMHkLVHyl4ZsqJgUElU4l0z2-1CDbSkCyS8vRyU4M3MJH--f5IPoWtKEk6lVHed4XM2TBhhImEySRNOqDxBdSZUq6la7Ov06K6hi6r6JkTItpLnqMZTLphU7Toquib4MHMGd1cwXcLCBY9DiTMbV87AFGfgjY343URrvfNjnK9xbzjCD6-dWzzqbwb4Ag9hjquZhYhf7GISigo7j_u-CN5WDi7RWQnTyl797gb6fOx-ZL3m4O2pn3UGTcOIlM3CKkmtyFlqpFK5SbkRtFSGq1RSMKJtS2MEa5U5pLkUlAAVJXCe58woEIQ30P2-d77MZ7Yw1i8iTPU8uhnEtQ7g9P_Eu4keh5WmVBHChdg0yH2DiaGqoi0PMCV6513vvOutd82kTvXW-4a7Of58oP5E8x8ZnX91</recordid><startdate>20240901</startdate><enddate>20240901</enddate><creator>Hafidz, Firdaus</creator><creator>Icanervilia, Ajeng Viska</creator><creator>Rizal, Muhammad Fikru</creator><creator>Listiani, Putri</creator><creator>Setyaningsih, Hermawati</creator><creator>Sasanti, Maria Lastri</creator><creator>Ekawati, Fitriana Murriya</creator><creator>Atthobari, Jarir At</creator><creator>Utami, Tofan Widya</creator><creator>Trirahmanto, Addin</creator><creator>Tjokroprawiro, Brahmana Askandar</creator><creator>Harsono, Ali Budi</creator><creator>Masytoh, Lusiana Siti</creator><creator>Haryani, Windi</creator><creator>Subekti, Yusuf</creator><creator>Nadjib, Mardiati</creator><general>West Asia Organization for Cancer Prevention</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-2906-8423</orcidid><orcidid>https://orcid.org/0000-0001-8676-7525</orcidid><orcidid>https://orcid.org/0000-0002-0064-3255</orcidid><orcidid>https://orcid.org/0000-0002-2014-3784</orcidid><orcidid>https://orcid.org/0000-0002-7035-4846</orcidid><orcidid>https://orcid.org/0000-0003-1658-3477</orcidid><orcidid>https://orcid.org/0000-0002-1428-9031</orcidid><orcidid>https://orcid.org/0000-0002-3622-0510</orcidid><orcidid>https://orcid.org/0000-0001-6342-321X</orcidid><orcidid>https://orcid.org/0000-0002-1787-4930</orcidid></search><sort><creationdate>20240901</creationdate><title>Economic Evaluation of Cervical Cancer Screening by HPV DNA, VIA, and Pap smear Methods in Indonesia</title><author>Hafidz, Firdaus ; Icanervilia, Ajeng Viska ; Rizal, Muhammad Fikru ; Listiani, Putri ; Setyaningsih, Hermawati ; Sasanti, Maria Lastri ; Ekawati, Fitriana Murriya ; Atthobari, Jarir At ; Utami, Tofan Widya ; Trirahmanto, Addin ; Tjokroprawiro, Brahmana Askandar ; Harsono, Ali Budi ; Masytoh, Lusiana Siti ; Haryani, Windi ; Subekti, Yusuf ; Nadjib, Mardiati</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2055-de751e4b29c577bc93c41f7c37951ac48efcc426fba9b5410a14fa33bb2c7a403</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Cost-Benefit Analysis</topic><topic>DNA, Viral - analysis</topic><topic>DNA, Viral - genetics</topic><topic>Early Detection of Cancer - economics</topic><topic>Early Detection of Cancer - methods</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Indonesia - epidemiology</topic><topic>Mass Screening - economics</topic><topic>Mass Screening - methods</topic><topic>Middle Aged</topic><topic>Papanicolaou Test - economics</topic><topic>Papillomaviridae - genetics</topic><topic>Papillomaviridae - isolation & purification</topic><topic>Papillomavirus Infections - diagnosis</topic><topic>Papillomavirus Infections - economics</topic><topic>Papillomavirus Infections - virology</topic><topic>Prognosis</topic><topic>Uterine Cervical Neoplasms - diagnosis</topic><topic>Uterine Cervical Neoplasms - economics</topic><topic>Uterine Cervical Neoplasms - virology</topic><topic>Vaginal Smears - economics</topic><topic>Vaginal Smears - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hafidz, Firdaus</creatorcontrib><creatorcontrib>Icanervilia, Ajeng Viska</creatorcontrib><creatorcontrib>Rizal, Muhammad Fikru</creatorcontrib><creatorcontrib>Listiani, Putri</creatorcontrib><creatorcontrib>Setyaningsih, Hermawati</creatorcontrib><creatorcontrib>Sasanti, Maria Lastri</creatorcontrib><creatorcontrib>Ekawati, Fitriana Murriya</creatorcontrib><creatorcontrib>Atthobari, Jarir At</creatorcontrib><creatorcontrib>Utami, Tofan Widya</creatorcontrib><creatorcontrib>Trirahmanto, Addin</creatorcontrib><creatorcontrib>Tjokroprawiro, Brahmana Askandar</creatorcontrib><creatorcontrib>Harsono, Ali Budi</creatorcontrib><creatorcontrib>Masytoh, Lusiana Siti</creatorcontrib><creatorcontrib>Haryani, Windi</creatorcontrib><creatorcontrib>Subekti, Yusuf</creatorcontrib><creatorcontrib>Nadjib, Mardiati</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Asian Pacific Journal of Cancer Prevention</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hafidz, Firdaus</au><au>Icanervilia, Ajeng Viska</au><au>Rizal, Muhammad Fikru</au><au>Listiani, Putri</au><au>Setyaningsih, Hermawati</au><au>Sasanti, Maria Lastri</au><au>Ekawati, Fitriana Murriya</au><au>Atthobari, Jarir At</au><au>Utami, Tofan Widya</au><au>Trirahmanto, Addin</au><au>Tjokroprawiro, Brahmana Askandar</au><au>Harsono, Ali Budi</au><au>Masytoh, Lusiana Siti</au><au>Haryani, Windi</au><au>Subekti, Yusuf</au><au>Nadjib, Mardiati</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Economic Evaluation of Cervical Cancer Screening by HPV DNA, VIA, and Pap smear Methods in Indonesia</atitle><jtitle>Asian Pacific Journal of Cancer Prevention</jtitle><addtitle>Asian Pac J Cancer Prev</addtitle><date>2024-09-01</date><risdate>2024</risdate><volume>25</volume><issue>9</issue><spage>3015</spage><epage>3022</epage><pages>3015-3022</pages><issn>2476-762X</issn><issn>1513-7368</issn><eissn>2476-762X</eissn><abstract>Cervical cancer occurs 80% in developing country including Indonesia and take place in the first rank of incidence rate and third rank in mortality rate in Asian Pacific. Natural history of cervical cancer gives a potential to get accurate screening method. Cervical cancer screening m in Indonesia use VIA and Pap smear method for women in age range 30 to 50 years old. Recently, HPV DNA test has been recommended in international and national policy as primary screening method for cervical cancer. This research aims to asses cost-effectiveness and economic implications of specific cervical cancer screening modalities.
Cost-effectiveness analysis was conducted from societal perspective. Cost data was collected from four hospitals in Indonesia. Direct medical costs were derived from discussions with an expert panel and hospital billing data, aligning with current practice guidelines. Direct and indirect non-medical costs were estimated from patient interviews. Effectiveness data for the screening methods were extracted from a systematic review of existing literature. Markov model design was used for cost-effectiveness analysis. Budget impact analysis used healthcare perspective method from its billing for cervical cancer patients.
Cervical cancer screening costs are calculated using direct medical, non-medical, and indirect expenses. Regarding to cost-effective analysis by incremental cost-effective ratio (ICER), pap smear for every 3 and 5 years is more cost-effective than VIA. HPV DNA also has the potential to be cost-effective. The budget impact analysis investigates scenarios, with a focus on negotiation-based cost reductions for HPV DNA testing. Controlling HPV DNA tariffs at USD 8.76 proves cost-effective.
In conclusion, pap smear is the most cost-effective modality, while HPV DNA has the potential to be cost-effective by reducing the unit cost. Despite favorable outcomes, challenges in implementation suggest a phased approach for resource equalization before full deployment.</abstract><cop>Thailand</cop><pub>West Asia Organization for Cancer Prevention</pub><pmid>39342578</pmid><doi>10.31557/APJCP.2024.25.9.3015</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-2906-8423</orcidid><orcidid>https://orcid.org/0000-0001-8676-7525</orcidid><orcidid>https://orcid.org/0000-0002-0064-3255</orcidid><orcidid>https://orcid.org/0000-0002-2014-3784</orcidid><orcidid>https://orcid.org/0000-0002-7035-4846</orcidid><orcidid>https://orcid.org/0000-0003-1658-3477</orcidid><orcidid>https://orcid.org/0000-0002-1428-9031</orcidid><orcidid>https://orcid.org/0000-0002-3622-0510</orcidid><orcidid>https://orcid.org/0000-0001-6342-321X</orcidid><orcidid>https://orcid.org/0000-0002-1787-4930</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Asian Pacific Journal of Cancer Prevention, 2024-09, Vol.25 (9), p.3015-3022 |
| issn | 2476-762X 1513-7368 2476-762X |
| language | eng |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free E- Journals |
| subjects | Adult Cost-Benefit Analysis DNA, Viral - analysis DNA, Viral - genetics Early Detection of Cancer - economics Early Detection of Cancer - methods Female Follow-Up Studies Humans Indonesia - epidemiology Mass Screening - economics Mass Screening - methods Middle Aged Papanicolaou Test - economics Papillomaviridae - genetics Papillomaviridae - isolation & purification Papillomavirus Infections - diagnosis Papillomavirus Infections - economics Papillomavirus Infections - virology Prognosis Uterine Cervical Neoplasms - diagnosis Uterine Cervical Neoplasms - economics Uterine Cervical Neoplasms - virology Vaginal Smears - economics Vaginal Smears - methods |
| title | Economic Evaluation of Cervical Cancer Screening by HPV DNA, VIA, and Pap smear Methods in Indonesia |
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