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Implementation costs of a multi-component program to increase human papillomavirus (HPV) vaccination in a network of pediatric clinics.

Introduction
HPV vaccination is both a clinically and cost-effective way to prevent HPV-related cancers. Increased focus on preventing HPV infection and HPV-related cancers has motivated development of strategies to increase adolescent vaccination rates. This analysis estimates the average cost associated with implementing programs aimed at increasing HPV vaccination from the perspective of the clinic decision makers. As providers and healthcare organizations consider vaccination initiatives, it is important for them to understand the costs associated with implementing these programs.


Methods
Healthcare provider assessment and feedback, reminders, and education; and parent education/reminder strategies were implemented in a large pediatric clinic network between October 2015 and February 2018 to improve HPV vaccination rates. A micro-costing method was used in 2018 to prospectively estimate program implementation costs with the clinic as the unit of analysis. A sensitivity analysis assessed the effects of variability in levels of participation.


Results
Assessment and feedback reports and provider education were implemented among 51 clinics at average per clinic cost of $786 and $368 respectively. Electronic vaccination reminders were delivered to providers and parents at a per clinic cost of $824. The parent education implementation cost was $2,126 per clinic.


Conclusion
The four complimentary HPV evidence-based strategies were delivered at a total cost of $157,534 or $4,749 per clinic, including staff training and participant recruitment, reaching 155,000 HPV vaccine eligible adolescents.