Cost/Effective Analysis of Anti-HPV Vaccination Programme in Italy: A Multi-Cohort Markov Model

Favato, Giampiero; Pieri, Vasco; Mills, Roger

doi:10.2139/ssrn.961847

Cited by 13 publications

(6 citation statements)

References 29 publications

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“…The cost-effectiveness evaluation of vaccination is based also on the design of developed programs. 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).…”

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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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%

Public health value of universal HPV vaccination

Audisio

Icardi

Isidori

et al. 2016

Critical Reviews in Oncology/Hematology

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“…biennial cytology) [85]. Two studies evaluated the implementation and economic consequences of a multi-cohort vaccination strategy [86,87]. At present, to be considered efficient from an economic point of view, health intervention should have an ICER (Incremental Cost Effectiveness Ratio) per QALY (Quality Adjusted Life Year) gained of less than £ 20,000 to £ 30,000 [88,89] (approximately € 30,000 to € 45,000).…”

Section: Discussionmentioning

confidence: 99%

Towards the eradication of HPV infection through universal specific vaccination

et al. 2013

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BackgroundThe Human Papillomavirus (HPV) is generally recognized to be the direct cause of cervical cancer. The development of effective anti-HPV vaccines, included in the portfolio of recommended vaccinations for any given community, led to the consolidation in many countries of immunization programs to prevent HPV-related cervical cancers. In recent years, increasing evidence in epidemiology and molecular biology have supported the oncogenic role of HPV in the development of other neoplasm including condylomas and penile, anal, vulvar, vaginal, and oro-pharyngeal cancers. Men play a key role in the paradigm of HPV infection: both as patients and as part of the mechanisms of transmission. Data show they are affected almost as often as women. Moreover, no screening procedures for HPV-related disease prevention are applied in men, who fail to undergo routine medical testing by any medical specialist at all. They also do not benefit from government prevention strategies.DiscussionA panel of experts convened to focus on scientific, medical, and economic studies, and on the achievements from health organizations’ intervention programs on the matter. One of the goals was to discuss on the critical issues emerging from the ongoing global implementation of HPV vaccination. A second goal was to identify contributions which could overcome the barriers that impede or delay effective vaccination programs whose purpose is to eradicate the HPV infection both in women and men.SummaryThe reviewed studies on the natural history of HPV infection and related diseases in women and men, the increasing experience of HPV vaccination in women, the analysis of clinical effectiveness vs economic efficacy of HPV vaccination, are even more supportive of the economic sustainability of vaccination programs both in women and men. Those achievements address increasing and needed attention to the issue of social equity in healthcare for both genders.

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“… Expected benefit of each of the two alternatives (E i ). 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—ISTAT 20 ).…”

Section: Methodsmentioning

confidence: 99%

“…More favourable economic results were obtained using predictive models that were based on a quadrivalent multicohort strategy of vaccination (three to four cohorts) 18. When a multicohort strategy of vaccination is adopted, a larger proportion of the female population aged between 12 and 25 years can be vaccinated in a shorter period of time (5–8 years) and an early reduction of costs can be expected.…”

Section: Introductionmentioning

confidence: 99%

“…More favourable economic results were obtained using predictive models that were based on a quadrivalent multicohort strategy of vaccination (three to four cohorts). 18 When a multicohort strategy of vaccination is adopted, a larger proportion of the female population aged between 12 and 25 years can be vaccinated in a shorter period of time (5–8 years) and an early reduction of costs can be expected. 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 ).…”

Section: Introductionmentioning

confidence: 99%

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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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Cost/Effective Analysis of Anti-HPV Vaccination Programme in Italy: A Multi-Cohort Markov Model

Cited by 13 publications

References 29 publications

Public health value of universal HPV vaccination

Public health value of universal HPV vaccination

Towards the eradication of HPV infection through universal specific vaccination

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

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