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HPV Vaccine Introduction in LMIC's: Guidance on the Use of Cost-Effectiveness Models

2011

This article is a literature review of HPV vaccination models suitable for low-income and middle-income country use to provide information about the feasibility of using such models in a developing country setting. The authors evaluated models in terms of their capacity, requirements, limitations and comparability.

Their literature review identified six HPV vaccination models suitable for low-income and middle-income country use and representative of the literature in terms of provenance and model structure. Each model was adapted by its developers using standardized data sets representative of two hypothetical developing countries (a low-income country with no screening and a middle-income country with limited screening). The authors compared model predictions before and after vaccination of adolescent girls in terms of HPV prevalence and cervical cancer incidence, as was the incremental cost-effectiveness ratio of vaccination under different scenarios.

The authors found that none of the models perfectly reproduced the standardized data set provided to the model developers. However, they agreed that large decreases in type 16/18 HPV prevalence and cervical cancer incidence are likely to occur following vaccination. The most influential factors affecting cost effectiveness were the discount rate, duration of vaccine protection, vaccine price and HPV prevalence. Demographic change, access to treatment and data resolution were found to be key issues to consider for models in developing countries.

 

Source:

Jit M, Demarteau N, Elbasha E et al. Human Papillomavirus Vaccine Introduction in Low-Income and Middle-Income Countries: Guidance on the Use of Cost-Effectiveness Models. BMC Medicine 2011; 9 (1): 54. https://doi.org/10.1186/1741-7015-9-54