Cost effectiveness of improving HPV vaccine uptake in underserved communities in the Netherlands

Abstract Background Vaccination coverage in underserved populations, including ethnic minorities and migrants within the European Region remains significantly lower than the national averages. This contributes to preventable disease burdens and widening health inequities. Within the framework of the RIVER-EU project, interventions were designed to address health system barriers to vaccine access. This study evaluates the cost-effectiveness of one of these interventions aimed at improving HPV vaccine uptake among the underserved populations in the Netherlands focusing on the Turkish and Moroccan communities. Methods A gender-neutral static cohort model considering six HPV-related cancers was developed to simulate the lifetime health and economic impacts of the intervention. Input parameters were sourced from national databases and published literature. Primary outcome measures were cancer cases and deaths averted and the incremental cost effectiveness ratio (ICER). Costs were adjusted to 2024 euros using the Dutch consumer price index (CPI), with discount rates of 3% and 1.5% applied on costs and effects respectively. Probabilistic and one-way sensitivity analyses assessed model and parameter uncertainty. Results Preliminary results estimated discounted incremental costs and QALYs of €1.04million and 627 QALYs respectively, resulting in an ICER of €1665 per QALY. These early results reflect reductions in HPV-related cancer cases and deaths from increased vaccination. Sensitivity analyses revealed that the model was most influenced by and intervention costs and vaccination coverage. Final results incorporating updated parameters will be presented during the conference. Conclusions Implementing targeted interventions to improve HPV vaccine uptake in underserved populations has the potential to be cost-effective while advancing health equity. These findings support scaling such strategies to close vaccination gaps and reduce HPV-related disease burdens. Key messages • Targeted interventions in marginalized communities can be cost-effective. • Improving HPV vaccine uptake in underserved populations promotes health equity.