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' recommendations: 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

URL for published report: http://gesdoc.isciii.es/gesdoccontroller?action=download&id=01/04/2013-3d0800b9f7

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Spain

Organisation Name: Agencia de Evaluacion de Tecnologias Sanitarias

Contact Address: 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: Luis M. Sánchez Gómez

Contact Email: luism.sanchez@isciii.es

Copyright: Agencia de Evaluacion de Tecnologias Sanitarias (AETS)