Cost-effectiveness of human papillomavirus vaccination among girls aged 9–16 years in China: a meta-analysis

Imported 2 v, 4 v, and 9vHPV vaccines are costly in China, whereas the domestic 2vHPV is more affordable. This study aimed to summarize cost-effectiveness evidence by pooling the incremental net monetary benefit (INB) of HPV vaccination for girls in China. We searched PubMed, Embase®, Web of Science, and Cochrane databases from inception to 18 January 2024, for cost-effectiveness analyses of 2vHPV, 4vHPV, and 9vHPV vaccines compared to no HPV vaccination (NoV) and to each other. All monetary units were adjusted to 2022 US dollars. INBs were calculated as the difference in incremental effectiveness multiplied by the willingness-to-pay threshold minus the incremental cost and pooled by vaccine type using random-effects or fixed-effects models. Sixteen studies involving 61 comparisons were included. The INBs (95% CI) for domestic 2vHPV, imported 2vHPV, 4vHPV, and 9vHPV vaccines, compared to NoV, were USD 569.99 (58.62, 1081.36), 186.39 (86.21, 286.57), 239.14 (142.46, 335.81), and 298.41 (198.31, 398.51), respectively. HPV vaccines were significantly cost-effective compared to NoV. 4vHPV vaccine was less cost-effective than imported 2vHPV vaccine, with an INB of USD − 693.98 (−1062.17, −325.79). HPV vaccines were cost-effective compared to NoV in China. Our findings would facilitate policy-making of HPV immunization programs.