Cost of community-based human papillomavirus self-sampling in Peru: A micro-costing study

Background Cost data of human papillomavirus (HPV) self-sampling programs from low-and-middle-income countries is limited. We estimated the total and unit costs associated with the Hope Project, a community-based HPV self-sampling social entrepreneurship in Peru. Methods We conducted a micro-costing analysis from the program perspective to determine the unit costs of (1) recruitment/training of community women (Hope Ladies); (2) Hope Ladies distributing HPV self-sampling kits in their communities and the laboratory testing; and (3) Hope Ladies linking screened women with follow-up care. A procedural manual was used to identify the program's activities. A structured questionnaire and in-depth interviews were conducted with administrators to estimate the resource/time associated with activities. We obtained unit costs for each input previously identified from budgets and expenditure reports. Findings From November 2018 to March 2020, the program recruited and trained 62Hope Ladies who distributed 4,882 HPV self-sampling kits in their communities. Of the screened women, 586 (12%) tested HPV positive. The annual cost per Hope Lady recruited/trained was $147 center dot 51 (2018 USD). The cost per HPV self-sampling kit distributed/tested was $45 center dot 39, the cost per woman followed up with results was $55 center dot 64, and the cost per HPV-positive woman identified was $378 center dot 14. Personnel and laboratory costs represented 56 center dot 1% and 24 center dot 7% of the total programmatic cost, respectively. Interpretation Our findings indicate that implementation of a community-based HPV self-sampling has competitive prices, which increases its likelihood to be feasible in Peru. Further economic evaluation is needed to quantify the incremental benefits of HPV self-sampling compared to more established options such as Pap tests. Copyright (c) 2021 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Automated summary

This study estimated the total and unit costs associated with a community-based HPV self-sampling program in Peru. The findings suggest that the implementation of this program has competitive prices and is likely to be feasible in Peru.