Cost of HPV Testing
The direct cost of HPV testing ranges from approximately $23-24 per test in both public and private settings, while conventional cytology costs approximately $11.50 per test and liquid-based cytology costs approximately $14 per test. 1
Individual Test Costs
Based on 2002 pricing data (adjusted to current context):
- HPV DNA testing: $23.43-$23.48 per test for 20,000 annual tests 1
- Conventional Pap smear: $11.53 per test for 100,000 annual examinations 1
- Liquid-based cytology (ThinPrep): $13.93 per test for 100,000 annual examinations 1
Population-Level Cost Implications
The economic burden varies dramatically based on screening strategy and frequency:
- Annual screening for women under 21: Estimated $21.7-$40 million annually for approximately 290,000 women screened 2
- Annual screening for women 65-75 years: Estimated $50-$90 million annually 2
These population costs exclude follow-up procedures, colposcopies, and treatment costs, making them conservative estimates. 2
Cost-Effectiveness Context
While individual HPV tests cost more than cytology, the overall screening strategy cost-effectiveness depends on screening interval:
- Annual screening (cytology alone or with HPV): Exceeds $500,000 per quality-adjusted life-year (QALY) gained 2
- Biennial screening: Approximately $150,000-$200,000 per QALY gained 2
- Screening every 3-5 years: Less than $100,000 per QALY gained 2
Primary HPV screening every 3 years is more cost-effective than annual cytology despite the higher per-test cost, because fewer total tests are needed over a lifetime while maintaining equivalent or superior cancer detection. 2
Comparative Strategy Costs
In a cohort of 99,549 women over 3 years: 3
- Co-testing (HPV + cytology) required 100,277 additional cytology tests and 566 additional colposcopies compared to primary HPV testing alone, adding $2.38 million in costs ($170,096 per additional CIN3+ case detected) 3
- Primary HPV testing was both more effective and less expensive than primary cytology alone 3
Important Cost Considerations
The high per-test cost of HPV testing ($23-24) compared to conventional cytology ($11.50) means integration into screening programs must be strategically planned. 1 The cost-effectiveness improves when HPV testing is used at longer intervals (every 3-5 years) rather than annually, and when targeted to women aged 30 years or older where HPV specificity is higher. 4, 5
Strategies using HPV testing have cost-per-QALY ratios ranging from $12,400-$16,600, which falls well within accepted cost-effectiveness thresholds. 4