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Cost Estimation of the New HPV/DNA Test Screening Procedure per Person among 35 Years Old Ever-Married Women in a District of Sri Lanka

Background: HPV/DNA screening test has an optimum sensitivity (92.9%) to detect cervical lesions. The objective of the study was to estimate the cost of cobas 4800 HPV/DNA test in thin prep cell collection media.

Methods: The cost estimation of the HPV/DNA specimen collection was done at a randomly selected community Well Woman Clinic (WWC) in the district of Sri Lanka. Five women, who were attended WWC for HPV/DNA specimen collection in September, October, and November 2018 were randomly selected for the cost estimation.

To estimate the cost incurred in laboratory screening of the HPV/DNA specimen by cobas 4800 HPV/DNA PCR test, a reference laboratory in the district was utilized. Checklists were developed to record all instruments and consumable items used in the clinic and laboratory, while record sheets were developed to record the time taken to complete all activities associated with taking an HPV/DNA specimen by the clinic and laboratory staff.

Five HPV/DNA specimen collection procedures were randomly selected at each of three sessions and the average time per procedure was calculated. Categories of staff involved in the procedure and staff time spent on the procedure were measured and recorded on three clinic days. Staff time spent on HPV/DNA specimen screening by an HPV/DNA testing machine in the laboratory was calculated on three working days (One day per month).

Results: The total estimated cost of the HPV/DNA specimen collection procedure incurred by the government in the community WWC was Rs.2569.38 (USD 13.81), while the total estimated unit cost in the laboratory procedure for HPV/DNA screening was Rs. 50.57(USD 0.27).Therefore the total estimated cost of the HPV/ DNA specimen screening procedure was Rs. 2619.95(USD 14.08). The estimated unit cost including administrative cost was Rs. 2881.95(USD 15.49).

Conclusion: Cobas HPV/DNA test is economically feasible to be incorporated into the national cervical cancer screening programme in Sri Lanka. It is necessary to further attempt alternative methods of cobas 4800 HPV/DNA test (i.e. dry swabs) to determine the most appropriate method for resource limited settings.


Perera KCM , Abeysena HTCS , Mapitigama N and De Silva D

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