[Economic evaluation of the introduction of the HPV vaccine in Spain to prevent cervical cancer]

Casado-Buesa MI, García-Hernández L, González-Enríquez J, Imaz I, Rubio B, Zegarra P
Record ID 32013000274
Authors' objectives: To review and analyze published models proposed for the economic evaluation of HPV vaccination with quadrivalent (types 16, 18, 6, 11) or bivalent (types 16, 18) vaccine in girls 11-14 year, compared with the situation of cervical cancer screening without vaccination. HPV vaccination programmes started in Spain in 2008.
Authors' recomendations: Most of the studies reviewed conclude that the introduction of HPV vaccination in adolescent girls could be a cost-effective strategy compared to the usual practice of screening. The analysis of the studies revealed the existence of significant uncertainties in modelling the natural history of the disease, the HPV infection and the cervical cancer, the vaccine effectiveness, the duration of protection and the acceptance and coverage achieved. The actual vaccine effectiveness in reducing incidence and mortality rates from cervical cancer is still unknown. It is also important to appreciate great variations in health care settings and screening of each health systems where these studies were carried out. The vaccination and screening strategy may be considered as a cost-utility option if the assumptions and values assigned to the variables in the base case are actual. Uncertainties in the used models and current lack of data about relevant parameters should not be ignored: vaccine effectiveness for cervical cancer prevention, duration of protection, changes in cervical cancer screening programs, changes in cervical cancer incidence, diagnosis and therapeutic efficacy in the coming decades. Together with results of similar studies in different contexts, the interpretation of these results requires maximum caution when moving to public health recommendations.
Project Status: Completed
Year Published: 2012
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Spain
MeSH Terms
  • Papillomavirus Vaccines
  • Spain
  • Uterine Cervical Neoplasms
Organisation Name: Agencia de Evaluacion de Tecnologias Sanitarias
Contact Address: Jose Luis de Sancho Martin, Instituto de Salud "Carlos III", Calle Sinesio Delgado 6, Pabellon 4, 28029 Madrid, Spain. Tel: +34 9 1 822 2005; Fax: +34 9 1 387 7841;
Contact Name: jsancho@isciii.es
Contact Email: jsancho@isciii.es
Copyright: Agencia de Evaluacion de Tecnologias Sanitarias (AETS)
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