Anti-HPV vaccination: A review of recent economic data for Italy

Mennini, Francesco Saverio; Costa, Silvano; Favato, Giampiero; Picardo, Mauro

doi:10.1016/j.vaccine.2009.02.052

Cited by 23 publications

(38 citation statements)

References 19 publications

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“…Indeed, depending on the number (1, 2, or 3) of eligible cohorts, the cost of HPV vaccination in Italy might be assumed in a range between € 55 and € 120 million (60). On the other hand, annual costs associated with HPV-related diseases amount to about € 250 million (47). With the HPV vaccination, the overall reduction of HPV-related events over time would produce a total decrease in costs of approximately € 132 million (47).…”

Section: Preventive Measuresmentioning

confidence: 99%

“…On the other hand, annual costs associated with HPV-related diseases amount to about € 250 million (47). With the HPV vaccination, the overall reduction of HPV-related events over time would produce a total decrease in costs of approximately € 132 million (47). In order to optimize the use of public financial resources, a multi-cohort vaccination program should be considered in order to reach a positive balance point between the need to accelerate the cost reduction of the invasive cervical cancer and the rational management of healthcare demand.…”

Section: Preventive Measuresmentioning

confidence: 99%

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Public health value of universal HPV vaccination

Audisio

Icardi

Isidori

et al. 2016

Critical Reviews in Oncology/Hematology

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Highlights► Human Papillomavirus vaccination demands urgent attention. ► The cost-effectiveness of including boys into HPV vaccination programs should be re-assessed. ► Steps must be taken to achieve the target of universal vaccination. ► There is sufficient evidence to urge the EU Community to eradicate all HPV related cancers. ► Policymakers must consider effective vaccination programs in the prevention of cancers. AbstractBackground: The story of Human Papillomavirus vaccination demands reflection not only

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Section: Preventive Measuresmentioning

confidence: 99%

Section: Preventive Measuresmentioning

confidence: 99%

Public health value of universal HPV vaccination

Audisio

Icardi

Isidori

et al. 2016

Critical Reviews in Oncology/Hematology

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“…Using recently published Italian data,14 18 21 the annual number of cervical events induced by HPV, as well as the number averted by both the screening and the quadrivalent vaccine (using a three-cohort strategy of vaccination), were estimated. These cases were related to the pertinent female population of 2006 (provided by the Italian National Institute of Statistics—ISTAT20).…”

Section: Methodsmentioning

confidence: 99%

“…A multicohort programme of vaccination using the quadrivalent vaccine was associated with a total saving of approximately €132 million, as a result of a reduction in the numbers of low-grade and high-grade cervical lesions, anogenital warts and invasive cervical cancers (table 1). 21…”

Section: Introductionmentioning

confidence: 99%

Governance of preventive Health Intervention and On time Verification of its Efficiency: the GIOVE Study

et al. 2012

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ObjectivesThe GIOVE Study was aimed to the achievement of allocative efficiency of the budget allocated to the prevention of human papillomavirus (HPV)-induced diseases. An ex-ante determination of the most efficient allocation of resources between screening and multicohort quadrivalent immunisation programmes was followed by the ex-post assessment of the allocative efficiency actually achieved after a 12-month period.DesignA bound optimisation model was developed to determine the ex-ante allocative efficiency of resources. The alternatives compared were the screening programme alone and the quadrivalent immunisation with access to screening. A sensitivity analysis was carried out to assess the uncertainty associated with the main inputs of the model. Subsequently, a cohort of girls with a complete recorded vaccination history were enrolled in an observational retrospective study for 18 months to ensure full compliance with the recommended schedule of vaccination (0, 2, 6 months) within a 12-month time horizon.SettingBasilicata region, in the south of Italy.Participants12 848 girls aged 12, 15, 18 or 25 years.InterventionImmunisation with quadrivalent anti-HPV vaccine.Outcome measuresThe vaccination coverage rate was considered to be the indicator of the best achievable benefit, given the budgetary constraints.ResultsAssuming a vaccine price of €100 per dose, a vaccination coverage rate of 59.6% was required for the most effective allocation of resources. The optimal rate of coverage was initially in favour of the multicohort strategy of vaccination against HPV (72.8%±2%). When the price paid for the quadrivalent vaccine dropped to €85 per dose, the most efficient coverage rate (69.5%) shifted closer to the immunisation rate actually achieved during the 12-month observation period.ConclusionsThe bound optimisation model demonstrated to be a useful approach to the ex-ante allocation and the ex-post assessment of the resources allocated to the implementation of a multicohort quadrivalent anti-HPV vaccination programme.

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“…A large number of economic evaluations have already confirmed the cost-effectiveness of different vaccination strategies. [5][6][7][8][9][10][11][12][13][14] However, standard economic analyses might not capture the full economic value of novel vaccination programs 15 because even the most sophisticated cost-effectiveness models are ultimately conducible to the accounting paradigm of the net present value (NVP). The NPV is the difference between a singlepoint discounted mean value for cash inflows and a single-point discounted mean for cash outflows, including the initial investment.…”

Section: Introductionmentioning

confidence: 99%

A Novel Method to Value Real Options in Health Care: The Case of a Multicohort Human Papillomavirus Vaccination Strategy

Favato

Baio

Capone

et al. 2013

Clinical Therapeutics

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Background: A large number of economic evaluations have already confirmed the cost-effectiveness of different human papillomavirus (HPV) vaccination strategies. Standard analyses might not capture the full economic value of novel vaccination programs because the cost-effectiveness paradigm fails to take into account the value of active management. Management decisions can be seen as real options, a term used to refer to the application of option pricing theory to the valuation of investments in nonfinancial assets in which much of the value is attributable to flexibility and learning over time.Objective: The aim of this article was to discuss the potential advantages shown by using the payoff method in the valuation of the cost-effectiveness of competing HPV immunization programs.Methods: This was the first study, to the best of our knowledge, to use the payoff method to determine the real option values of 4 different HPV vaccination strategies targeting female subjects aged 12, 15, 18, and 25 years. The payoff method derives the real option value from the triangular payoff distribution of the project's net present value, which is treated as a triangular fuzzy number. To inform the real option model, cost-effectiveness data were derived from an empirically calibrated Bayesian model designed to assess the cost-effectiveness of a multicohort HPV vaccination strategy in the context of the current cervical cancer screening program in Italy. A net health benefit approach was used to calculate the expected fuzzy net present value for each of the 4 vaccination strategies evaluated.Results: Costs per quality-adjusted life-year gained seemed to be related to the number of cohorts targeted: a single cohort of girls aged 12 years (€10,955 [95% CI, -1,021 to 28,212]) revealed the lowest cost among the 4 alternative strategies evaluated. The real option valuation challenged the costeffectiveness dominance of a single cohort of 12-yearold girls. The simultaneous vaccination of 2 cohorts of girls aged 12 and 15 years yielded a real option value (€17,723) equivalent to that attributed to a single cohort of 12-year-old girls (€17,460).Conclusions: The payoff method showed distinctive advantages in the valuation of the cost-effectiveness of competing health care interventions, essentially determined by the replacement of the nonfuzzy numbers that are commonly used in cost-effectiveness analysis models, with fuzzy numbers as an input to inform the real option pricing method. The real option approach to value uncertainty makes policy making in health care an evolutionary process and creates a new "space" for decision-making choices. (Clin Ther.

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Anti-HPV vaccination: A review of recent economic data for Italy

Cited by 23 publications

References 19 publications

Public health value of universal HPV vaccination

Public health value of universal HPV vaccination

Governance of preventive Health Intervention and On time Verification of its Efficiency: the GIOVE Study

A Novel Method to Value Real Options in Health Care: The Case of a Multicohort Human Papillomavirus Vaccination Strategy

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