Pink, Joshua, Parker, Benjamin A. and Petrou, Stavros (2016) Cost effectiveness of HPV Vaccination : a systematic review of modelling approaches. PharmacoEconomics, 34 (9). pp. 847-861. doi:10.1007/s40273-016-0407-y

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Abstract

Background
A large number of economic evaluations have been published that assess alternative possible human papillomavirus (HPV) vaccination strategies. Understanding differences in the modelling methodologies used in these studies is important to assess the accuracy, comparability and generalisability of their results.
Objectives
The aim of this review was to identify published economic models of HPV vaccination programmes and understand how characteristics of these studies vary by geographical area, date of publication and the policy question being addressed.
Methods
We performed literature searches in MEDLINE, Embase, Econlit, The Health Economic Evaluations Database (HEED) and The National Health Service Economic Evaluation Database (NHS EED). From the 1189 unique studies retrieved, 65 studies were included for data extraction based on a priori eligibility criteria. Two authors independently reviewed these articles to determine eligibility for the final review. Data were extracted from the selected studies, focussing on six key structural or methodological themes covering different aspects of the model(s) used that may influence cost-effectiveness results.
Results
More recently published studies tend to model a larger number of HPV strains, and include a larger number of HPV-associated diseases. Studies published in Europe and North America also tend to include a larger number of diseases and are more likely to incorporate the impact of herd immunity and to use more realistic assumptions around vaccine efficacy and coverage. Studies based on previous models often do not include sufficiently robust justifications as to the applicability of the adapted model to the new context.
Conclusions
The considerable between-study heterogeneity in economic evaluations of HPV vaccination programmes makes comparisons between studies difficult, as observed differences in cost effectiveness may be driven by differences in methodology as well as by variations in funding and delivery models and estimates of model parameters. Studies should consistently report not only all simplifying assumptions made but also the estimated impact of these assumptions on the cost-effectiveness results.

Item Type:	Journal Article
Subjects:	Q Science > QR Microbiology > QR355 Virology R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions:	Faculty of Medicine > Warwick Medical School > Health Sciences > Clinical Trials Unit Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Papillomaviruses -- Vaccination -- Cost effectiveness, Papillomaviruses -- Treatment -- Cost effectiveness, Systematic reviews (Medical research)
Journal or Publication Title:	PharmacoEconomics
Publisher:	Adis International Ltd.
ISSN:	1170-7690
Official Date:	September 2016
Dates:	Date Event September 2016 Published 13 May 2016 Available
Date of first compliant deposit:	26 January 2017
Volume:	34
Number:	9
Page Range:	pp. 847-861
DOI:	10.1007/s40273-016-0407-y
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access

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