open access

Vol 23, No 6 (2018)
Special Issue Papers
Published online: 2018-11-01
Submitted: 2018-01-08
Get Citation

Present challenges in cervical cancer prevention: Answers from cost-effectiveness analyses

Mireia Diaz, Silvia de Sanjosé, F. Xavier Bosch, Laia Bruni
DOI: 10.1016/j.rpor.2018.04.006
·
Rep Pract Oncol Radiother 2018;23(6):484-494.

open access

Vol 23, No 6 (2018)
Special Issue Papers
Published online: 2018-11-01
Submitted: 2018-01-08

Abstract

Simulation models are commonly used to address important health policy issues that cannot be explored through experimental studies. These models are especially useful to determine a set of strategies that result in a good value for money (cost-effectiveness). Several mathematical models simulating the natural history of HPV and related diseases, especially cervical cancer, have been developed to calculate a relative effectiveness and cost-effectiveness of HPV vaccination and cervical cancer screening interventions. Virtually all cost-effectiveness analyses identify HPV vaccination programmes for preadolescent girls to be cost-effective, even for relatively low vaccination coverage rates. Routine vaccination of preadolescent girls is the primary target population for HPV vaccination as it shows to provide the greatest health impact. Cost-effectiveness analyses assessing other vaccine target groups are less conclusive. Adding additional age-cohorts would accelerate health benefits in some years, although cost-effectiveness becomes less favourable as age at vaccination increases. Including men in HPV vaccination programmes may be a less efficient strategy if done at the expense of female vaccination coverage for reducing the burden of HPV in the population. However, as the HPV vaccine price decreases, the cost-effectiveness of universal vaccination improves, becoming equally as efficient as female-only vaccination. Vaccine price is a decisive factor in the cost-effectiveness analyses. The lower the price, the greater the likelihood that vaccination groups other than the primary target would be considered cost-effective.

Abstract

Simulation models are commonly used to address important health policy issues that cannot be explored through experimental studies. These models are especially useful to determine a set of strategies that result in a good value for money (cost-effectiveness). Several mathematical models simulating the natural history of HPV and related diseases, especially cervical cancer, have been developed to calculate a relative effectiveness and cost-effectiveness of HPV vaccination and cervical cancer screening interventions. Virtually all cost-effectiveness analyses identify HPV vaccination programmes for preadolescent girls to be cost-effective, even for relatively low vaccination coverage rates. Routine vaccination of preadolescent girls is the primary target population for HPV vaccination as it shows to provide the greatest health impact. Cost-effectiveness analyses assessing other vaccine target groups are less conclusive. Adding additional age-cohorts would accelerate health benefits in some years, although cost-effectiveness becomes less favourable as age at vaccination increases. Including men in HPV vaccination programmes may be a less efficient strategy if done at the expense of female vaccination coverage for reducing the burden of HPV in the population. However, as the HPV vaccine price decreases, the cost-effectiveness of universal vaccination improves, becoming equally as efficient as female-only vaccination. Vaccine price is a decisive factor in the cost-effectiveness analyses. The lower the price, the greater the likelihood that vaccination groups other than the primary target would be considered cost-effective.

Get Citation

Keywords

Cost-effectiveness; HPV vaccination; HPV-related diseases; Gender-neutral

About this article
Title

Present challenges in cervical cancer prevention: Answers from cost-effectiveness analyses

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 23, No 6 (2018)

Pages

484-494

Published online

2018-11-01

DOI

10.1016/j.rpor.2018.04.006

Bibliographic record

Rep Pract Oncol Radiother 2018;23(6):484-494.

Keywords

Cost-effectiveness
HPV vaccination
HPV-related diseases
Gender-neutral

Authors

Mireia Diaz
Silvia de Sanjosé
F. Xavier Bosch
Laia Bruni

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