Effectiveness and Cost Effectiveness of Human Papillomavirus Vaccine
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The recent approval of human papillomavirus (HPV) vaccine means that decision makers need information beyond that available from randomized clinical trials to recommend funding for this vaccination programme. Modelling and economic studies have addressed some of those information needs. We conducted a qualitative systematic review to summarize the existing data. Review articles were obtained from an extensive literature search on studies using mathematical modelling (either a Markov or transmission dynamic model) to determine the effectiveness or cost effectiveness of an HPV vaccine compared with the current cytology-based Pap smear screening programme.
A total of 21 studies (but 22 models) were included in the review after being assessed for methodological quality. All of the included studies had used a mathematical model to determine the effectiveness of an HPV vaccine, whilst 13 had also conducted a cost-effectiveness analysis. Although the studies used different model structures, baseline parameters and assumptions, all studies showed that vaccination would decrease rates of HPV infection, precancerous lesions and cervical cancer. Studies had a consistent message with respect to cost effectiveness: a female-only vaccination programme is cost effective compared with the current cytology-based Pap smear screening programme, while the cost effectiveness of a male and female vaccination programme is generally not cost effective compared with female-only vaccination.
KeywordsCervical Cancer Cervical Intraepithelial Neoplasia Vaccine Efficacy Genital Wart Invasive Cervical Cancer
G. Ogilvie has previously received grants from Merck and Co. for an investigator-driven study on prevalence of HPV in British Columbia, Canada. The other authors have no conflicts of interest that are directly relevant to the content of this review. No sources of funding were used to assist in the preparation of this review.
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