HPV vaccination in Indonesia:A health-economic & comparative perspective

Human Papillomavirus (HPV) is an important cause of cancer, inclusive cervical cancer disease. Despite preventive efforts, the clinical and economic burden of cervical cancer remains high. With non-optimal performance of available cervical screening programs, HPV vaccination becomes an alternative consideration for reducing cervical cancer related burden, inclusive in the Indonesian context. However, the introduction of HPV vaccination in Indonesia is dealing with many challenges, such as limited human resources, developing infrastructure and most importantly the national budget.Considering the cost-effectiveness of cervical cancer prevention implementation in the Netherlands as a reference, this study generates comprehensive evidence on cervical cancer prevention strategies in Indonesia, particularly HPV vaccination and cervical screening. Using several concepts form health economic evaluations, this study also showed that, using societal and governmental perspectives, the addition of HPV vaccination on top of cervical screening will provide substantial benefits. In addition, the identification of potential challenges for developing countries in general and Indonesia in particular, several implementation strategies should be considered in Indonesia in order to significantly reduce the cervical cancer-related burden