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ArticlePublication 2014Cost-Effectiveness of Female HPV Vaccination in 179 Countries: A PRIME Modelling Study
The authors present a simple generic model, Papillomavirus Rapid Interface for Modelling and Economics (PRIME), …
The authors present a simple generic model, Papillomavirus Rapid Interface for Modelling and Economics (PRIME), used to assess cost-effectiveness and health effects of vaccination of girls against HPV before sexual debut in terms of burden of cervical cancer and mortality. The PRIME models incidence according to proposed vaccine efficacy against HPV 16/18, vaccine coverage, cervical cancer incidence and mortality, and HPV type distribution. It assumes lifelong vaccine protection and no changes to other screening programs…
Infectious Diseases | Health Outcomes | Mathematical Models | Calibration/Validation | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Health/Medicine | Global | Sub-Saharan Africa | Middle East & North Africa | Latin America & Caribbean | Asia & Pacific -
ArticlePublication 2007Multiparameter Calibration of a Natural History Model of Cervical Cancer
This paper presents a two-step approach to model calibration of a comprehensive natural history model …
This paper presents a two-step approach to model calibration of a comprehensive natural history model of human papillomavirus (HPV) and cervical cancer. Using primary epidemiologic data from a longitudinal study of women in Brazil, a plausible range for each input parameter was identified that would produce model output within the 95% confidence intervals of the data. The authors then performed a simultaneous search over all input parameters to identify parameter sets that produced output consistent…
Infectious Diseases | Mathematical Models | Microsimulation | Calibration/Validation | Chronic Disease/Risk | Health/Medicine | Latin America & Caribbean -
ArticlePublication 2007Modeling HPV and Cervical Cancer in the U.S. for Analyses of Screening and Vaccination
This paper discusses a model of human papillomavirus (HPV) and cervical cancer that incorporates uncertainty …
This paper discusses a model of human papillomavirus (HPV) and cervical cancer that incorporates uncertainty about the natural history of disease that was used to provide quantitative insight into U.S. policy choices for cervical cancer prevention. The authors developed a stochastic microsimulation of cervical cancer that distinguishes different HPV types by their incidence, clearance, persistence, and progression. For each set of sampled input parameters, likelihood-based goodness-of-fit (GOF) scores were computed based on comparisons between model-predicted…
Infectious Diseases | Microsimulation | Calibration/Validation | Chronic Disease/Risk | Clinical Care | Health/Medicine | Science/Technology | North America -
ReviewPublication 2008Modeling Cervical Cancer Prevention in Developed Countries
Decision-analytic models are increasingly developed to simulate disease burden and interventions in different settings in …
Decision-analytic models are increasingly developed to simulate disease burden and interventions in different settings in order to evaluate the benefits and cost-effectiveness of primary and secondary interventions. This article is a review of mathematical models that have been used to evaluate HPV vaccination in the context of developed countries with existing screening programs. Despite variations in model assumptions and uncertainty in existing data, pre-adolescent vaccination of females in the setting of current screening practices has…
Infectious Diseases | Mathematical Models | State-Transition | Dynamic Transmission | Microsimulation | Calibration/Validation | Chronic Disease/Risk | Health/Medicine | Science/Technology -
GuidelinesPublication 2011HPV Vaccine Introduction in LMIC's: Guidance on the Use of Cost-Effectiveness Models
This article is a literature review of HPV vaccination models suitable for low-income and middle-income …
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…
Infectious Diseases | Mathematical Models | Calibration/Validation | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Clinical Care | Health/Medicine | Science/Technology | Global -
GuidelinesPublication 2013Economic Analyses to Support Decisions about HPV Vaccination in Low- and Middle-Income Countries: Consensus Report and Guide
Low- and middle-income countries need to consider economic issues such as cost-effectiveness, affordability and sustainability …
Low- and middle-income countries need to consider economic issues such as cost-effectiveness, affordability and sustainability before introducing a program for human papillomavirus (HPV) vaccination. However, many such countries lack the technical capacity and data to conduct their own analyses. This report describes the consensus of an expert group convened by the World Health Organization, prioritizing key issues to be addressed when considering economic analyses to support HPV vaccine introduction in these countries. The expert group…
Infectious Diseases | Costing Methods | Health Outcomes | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Economics/Finance | Health/Medicine | Science/Technology | Sub-Saharan Africa | Middle East & North Africa | Latin America & Caribbean | Asia & Pacific -
ReportPublication 2015Chapter 4: Cervical Cancer
This chapter focuses on the possibility of primary prevention of cervical cancer as a result …
This chapter focuses on the possibility of primary prevention of cervical cancer as a result of the introduction of two commercially available vaccines against human papillomavirus (HPV). Few low- and middle-income countries (LMICs) have initiated or sustained cytology-based cervical cancer prevention programs, and these countries experience very high incidence and mortality rates. Fortunately, alternative strategies to prevent cervical cancer have been investigated and extensively evaluated in these settings. The authors report findings from cost-effectiveness analyses…
Infectious Diseases | Mathematical Models | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Clinical Care | Health/Medicine | Science/Technology | Global -
ArticlePublication 2011Health and Economic Impact of HPV 16/18 Vaccination and Cervical Cancer Screening in Eastern Africa
In this article the authors use epidemiologic data from Kenya, Mozambique, Tanzania, Uganda, and Zimbabwe …
In this article the authors use epidemiologic data from Kenya, Mozambique, Tanzania, Uganda, and Zimbabwe to develop models of HPV-related infection and disease. For each country, they assessed HPV vaccination of girls before age 12 followed by screening with HPV DNA testing once, twice, or three times per lifetime (at ages 35, 40, 45). For women over age 30, they assessed only screening (with HPV DNA testing up to three times per lifetime or VIA…
Infectious Diseases | Microsimulation | Calibration/Validation | Cost-Effectiveness Analysis | Chronic Disease/Risk | Clinical Care | Economics/Finance | Health/Medicine | Science/Technology | Sub-Saharan Africa -
ArticlePublication 2007Including Boys in an HPV Vaccination Program: A CEA in a Low-Resource Setting
This paper looks at the cost-effectiveness of including boys vs girls alone in a pre-adolescent vaccination …
This paper looks at the cost-effectiveness of including boys vs girls alone in a pre-adolescent vaccination program against human papillomavirus (HPV) types 16 and 18 in Brazil. Using demographic, epidemiological, and cancer data from Brazil, the authors developed a dynamic transmission model of HPV infection between males and females. Model-projected reductions in HPV incidence under different vaccination scenarios were applied to a stochastic model of cervical carcinogenesis to project lifetime costs and benefits. They found that at 90%…
Infectious Diseases | Microsimulation | Calibration/Validation | Cost-Effectiveness Analysis | Chronic Disease/Risk | Clinical Care | Health/Medicine | Latin America & Caribbean -
ReviewPublication 2006Modelling the Impact of HPV Vaccines on Cervical Cancer and Screening Programmes
The impact of human papillomavirus (HPV)-16/18 vaccination on the incidence of infection and disease can …
The impact of human papillomavirus (HPV)-16/18 vaccination on the incidence of infection and disease can be explored in a range of different models. Here we explore the epidemiological and economic impact of vaccination where screening is absent and where it is well established. The importance for epidemiology of assumptions about naturally-acquired immunity and heterogeneity in risk behaviors are highlighted, as are the importance for health economic outcomes of vaccine costs and the ability to modify…
Infectious Diseases | Health Outcomes | Mathematical Models | Decision Analysis | Chronic Disease/Risk | Health Systems | Clinical Care | Economics/Finance | Health/Medicine | Science/Technology | Global -
ReviewPublication 2006Cost-Effectiveness of Cervical Cancer Screening
In the last two decades, computer-based models of cervical cancer screening have been used to …
In the last two decades, computer-based models of cervical cancer screening have been used to evaluate the cost-effectiveness of different secondary prevention policies. Analyses in countries with existing screening programs have focused on identifying the optimal screening interval, ages for starting and stopping screening, and consideration of enhancements to conventional cytology, such as human papillomavirus (HPV)-DNA testing as a triage for equivocal results or as a primary screening test for women over the age of…
Infectious Diseases | Mathematical Models | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Clinical Care | Health/Medicine | Science/Technology | Global -
ReviewPublication 2006Public Health Policy for Cervical Cancer Prevention: Decision Science, Economic Evaluation, & Mathematical Modeling
Several factors are changing the landscape of cervical cancer control, including a better understanding of …
Several factors are changing the landscape of cervical cancer control, including a better understanding of the natural history of human papillomavirus (HPV), reliable assays for detecting high-risk HPV infections, and a soon to be available HPV-16/18 vaccine. There are important differences in the relevant policy questions for different settings. By synthesizing and integrating the best available data, the use of modeling in a decision analytic framework can identify those factors most likely to influence outcomes,…
Infectious Diseases | Mathematical Models | Decision Analysis | Cost-Effectiveness Analysis | Chronic Disease/Risk | Economics/Finance | Health/Medicine | Science/Technology | Global -
ArticlePublication 2009Cost-Effectiveness of HPV Vaccination and Cervical Cancer Screening in Women Aged 30+ Years in the U.S.
The objective of the study was to assess the health and economic outcomes of HPV …
The objective of the study was to assess the health and economic outcomes of HPV vaccination in older U.S. women. The authors conducted a cost-effectiveness analysis with an empirically calibrated model using data from published literature; interventions included HPV vaccination added to screening strategies that differ by test (cytology or HPV DNA testing), frequency, and start age versus screening alone.They found that in the context of annual or biennial screening, HPV vaccination of women aged…
Infectious Diseases | Microsimulation | Cost-Effectiveness Analysis | Chronic Disease/Risk | Clinical Care | Economics/Finance | Health/Medicine | Science/Technology | North America -
ArticlePublication 2009Cost Effectiveness Analysis of Including Boys in a HPV Vaccination Program in the U.S.
This article reports on a societal-perspective cost effectiveness analysis of including preadolescent boys in a …
This article reports on a societal-perspective cost effectiveness analysis of including preadolescent boys in a routine human papillomavirus (HPV) vaccination program for preadolescent girls. The analysis included girls and boys aged 12 years; interventions included HPV vaccination of girls alone and of girls and boys in the context of screening for cervical cancer. The authors found that with 75% vaccination coverage and an assumption of complete, lifelong vaccine efficacy, routine HPV vaccination of 12-year-old girls…
Infectious Diseases | Dynamic Transmission | Microsimulation | Calibration/Validation | Cost-Effectiveness Analysis | Chronic Disease/Risk | Clinical Care | Economics/Finance | Health/Medicine | North America -
ArticlePublication 2008Mathematical Models of Cervical Cancer Prevention in Latin America and the Caribbean
This article reports on a model-based approach estimated averted cervical cancer cases and deaths, disability-adjusted …
This article reports on a model-based approach estimated averted cervical cancer cases and deaths, disability-adjusted life years (DALYs) and incremental cost-effectiveness ratios (I$/DALY averted) for human papillomavirus (HPV) vaccination of young adolescent girls using population and epidemiologic data for 33 countries in Latin America and the Caribbean (LAC). The authors found that an absolute reduction in lifetime cancer risk varied between countries, depending on incidence, proportion attributable to HPV-16 and 18, and population age-structure; for…
Infectious Diseases | Costing Methods | State-Transition | Microsimulation | Calibration/Validation | Cost-Effectiveness Analysis | Chronic Disease/Risk | Economics/Finance | Health/Medicine | Science/Technology | Latin America & Caribbean -
ArticlePublication 2008Mathematical Models of Cervical Cancer Prevention in the Asia Pacific Region
This article reports on a model-based approach to estimate averted cervical cancer cases and deaths, …
This article reports on a model-based approach to estimate averted cervical cancer cases and deaths, disability-adjusted life years (DALYs) and incremental cost-effectiveness ratios (I$/DALY averted) for vaccination of young adolescent girls against human papillomavirus (HPV) types 16 and 18. The authors used population-based and epidemiologic data for 25 countries in Asia (22 GAVI-Alliance eligible countries, Thailand, China and Japan). They found that an absolute reduction in lifetime cancer risk varied across countries, depending on incidence,…
Infectious Diseases | Mathematical Models | Microsimulation | Calibration/Validation | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Economics/Finance | Health/Medicine | Science/Technology | Asia & Pacific -
ArticlePublication 2008Health and Economic Impact of HPV 16 and 18 Vaccination and Cervical Cancer Screening in India
As cervical cancer is a leading cause of cancer death among women in low-income countries, …
As cervical cancer is a leading cause of cancer death among women in low-income countries, with approximately 25% of cases worldwide occurring in India, these authors estimated the potential health and economic impact of different cervical cancer prevention strategies in India. After empirically calibrating a cervical cancer model to country-specific epidemiologic data, they projected cancer incidence, life expectancy, and lifetime costs (I$2005), and calculated incremental cost-effectiveness ratios (I$/YLS) for the following strategies: pre-adolescent vaccination of…
Infectious Diseases | Microsimulation | Calibration/Validation | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Clinical Care | Economics/Finance | Health/Medicine | Science/Technology | Asia & Pacific -
ArticlePublication 2008Health and Economic Implications of HPV Vaccination in the U.S.
This article reports on a study using models of HPV-16 and HPV-18 transmission and cervical …
This article reports on a study using models of HPV-16 and HPV-18 transmission and cervical carcinogenesis to compare the health and economic outcomes of vaccinating preadolescent girls in the US (at 12 years of age), and vaccinating older girls and women in catch-up programs (to 18, 21, or 26 years of age). The study also examined the health benefits of averting other HPV-16-related and HPV-18-related cancers, the prevention of HPV-6-related and HPV-11-related genital warts and…
Infectious Diseases | Dynamic Transmission | Microsimulation | Calibration/Validation | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Clinical Care | Economics/Finance | Health/Medicine | Science/Technology | North America
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