Cn4 HPV-Based Primary Cervical Cancer Screening in Germany. Cost-Effectiveness Results From a Decision-Analytic Modeling Study

Health Technology Assessment on Cervical Cancer Screening, 2000–2014

“…In addition to diagnostic accuracy, eight reports also examined cervical cancer incidence (8;14;20;26;28;37;39;41), and five reports examined mortality due to cervical cancer as clinical endpoints (8;26;28;37;41). Finally, specimen quality was examined in 45 percent (twenty of forty-four) of all reports (8;14;19;20;22–26;30–32;39;40;42–47).…”

“…In total, thrity-six of forty-four HTAs carried out a health economic analysis. A primary cost-effectiveness analysis was the most commonly used health economic model, with twenty HTAs carrying out this type of analysis (11;14–16;9;20;22;24–26;28;29;31;35;39;42;46–49). Nine HTAs conducted a secondary cost-effectiveness analysis (10;34;36;38;40;41;43;50;51), seven HTAs developed a budget impact model (8;13;23;27;32;33;45), and three HTAs carried out both a cost-effectiveness and budget impact analysis (22;46;48).…”

“…In total, there were twenty-eight reports which examined adjunct testing for use with the main intervention, either as a triage or co-test (8;9;11–14;16;18;22;24;26–28;30–35;37;40;43;45;46;49–51). Of the forty-four HTA reports included in this review, 50 percent (twenty-two of forty-four) examined modifying testing intervals for various screening technologies to find optimal screening algorithms (8;14;16;19;20;22;24;26;28;30;31;33–35;37–42;49–51). Furthermore, rather than assessing one screening program for all women of screening age, seventeen HTAs considered a patient's age group in making specific screening recommendations (8;13;14;22;24;26–28;30;31;33;34;41;45;49–51).…”

“…Of the forty-four HTA reports included in this review, 50 percent (twenty-two of forty-four) examined modifying testing intervals for various screening technologies to find optimal screening algorithms (8;14;16;19;20;22;24;26;28;30;31;33–35;37–42;49–51). Furthermore, rather than assessing one screening program for all women of screening age, seventeen HTAs considered a patient's age group in making specific screening recommendations (8;13;14;22;24;26–28;30;31;33;34;41;45;49–51). Twelve reports also considered the impact of introducing a new test on a patient's stress and anxiety through Patient Reported Outcomes (8;13;18;24;26;28;33;35;37;38;50;51), a common metric used in HTAs evaluating HPV tests.…”

“…Furthermore, rather than assessing one screening program for all women of screening age, seventeen HTAs considered a patient's age group in making specific screening recommendations (8;13;14;22;24;26–28;30;31;33;34;41;45;49–51). Twelve reports also considered the impact of introducing a new test on a patient's stress and anxiety through Patient Reported Outcomes (8;13;18;24;26;28;33;35;37;38;50;51), a common metric used in HTAs evaluating HPV tests. A summary of these important outcome metrics can be found in Table 2.…”