Human papillomavirus vaccine introduction in low-income and middle-income countries: guidance on the use of cost-effectiveness models

 

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dc.contributor.author Jit, Mark en_ZA
dc.contributor.author Demarteau, Nadia en_ZA
dc.contributor.author Elbasha, Elamin en_ZA
dc.contributor.author Ginsberg, Gary en_ZA
dc.contributor.author Kim, Jane en_ZA
dc.contributor.author Praditsitthikorn, Naiyana en_ZA
dc.contributor.author Sinanovic, Edina en_ZA
dc.contributor.author Hutubessy, Raymond en_ZA
dc.date.accessioned 2015-10-28T06:55:09Z
dc.date.available 2015-10-28T06:55:09Z
dc.date.issued 2011 en_ZA
dc.identifier.citation Jit, M., Demarteau, N., Elbasha, E., Ginsberg, G., Kim, J., Praditsitthikorn, N., ... & Hutubessy, R. (2011). Human papillomavirus vaccine introduction in low-income and middle-income countries: guidance on the use of cost-effectiveness models. BMC medicine, 9(1), 54. en_ZA
dc.identifier.uri http://hdl.handle.net/11427/14441
dc.identifier.uri http://dx.doi.org/10.1186/1741-7015-9-54
dc.description.abstract BACKGROUND:The World Health Organization (WHO) recommends that the cost effectiveness of introducing human papillomavirus (HPV) vaccination is considered before such a strategy is implemented. However, developing countries often lack the technical capacity to perform and interpret results of economic appraisals of vaccines. To provide information about the feasibility of using such models in a developing country setting, we evaluated models of HPV vaccination in terms of their capacity, requirements, limitations and comparability. METHODS: A 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 standardised data sets representative of two hypothetical developing countries (a low-income country with no screening and a middle-income country with limited screening). Model predictions before and after vaccination of adolescent girls were compared in terms of HPV prevalence and cervical cancer incidence, as was the incremental cost-effectiveness ratio of vaccination under different scenarios. RESULTS: None of the models perfectly reproduced the standardised 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. Apart from the Thai model (in which vaccine and non-vaccine HPV types were combined), vaccine-type HPV prevalence dropped by 75% to 100%, and vaccine-type cervical cancer incidence dropped by 80% to 100% across the models (averaging over age groups). 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. CONCLUSIONS: The results indicated the usefulness of considering results from several models and sets of modelling assumptions in decision making. Modelling groups were prepared to share their models and expertise to work with stakeholders in developing countries.Please see related article: http://www.biomedcentral.com/1741-7007/9/55 en_ZA
dc.language.iso eng en_ZA
dc.publisher BioMed Central Ltd en_ZA
dc.rights This is an Open Access article distributed under the terms of the Creative Commons Attribution License en_ZA
dc.rights.uri http://creativecommons.org/licenses/by/2.0 en_ZA
dc.source BMC Medicine en_ZA
dc.source.uri http://www.biomedcentral.com/bmcmed/ en_ZA
dc.subject.other Cost-Benefit Analysis en_ZA
dc.subject.other Models, Statistical en_ZA
dc.subject.other Papillomavirus Infections en_ZA
dc.subject.other Papillomavirus Vaccines en_ZA
dc.subject.other Uterine Cervical Neoplasms en_ZA
dc.title Human papillomavirus vaccine introduction in low-income and middle-income countries: guidance on the use of cost-effectiveness models en_ZA
dc.type Journal Article en_ZA
dc.rights.holder 2011 World Health Organization; licensee BioMed Central Ltd. en_ZA
uct.type.publication Research en_ZA
uct.type.resource Article en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Health Economics Unit en_ZA
uct.type.filetype Text
uct.type.filetype Image
dc.identifier.apacitation Jit, M., Demarteau, N., Elbasha, E., Ginsberg, G., Kim, J., Praditsitthikorn, N., ... Hutubessy, R. (2011). Human papillomavirus vaccine introduction in low-income and middle-income countries: guidance on the use of cost-effectiveness models. <i>BMC Medicine</i>, http://hdl.handle.net/11427/14441 en_ZA
dc.identifier.chicagocitation Jit, Mark, Nadia Demarteau, Elamin Elbasha, Gary Ginsberg, Jane Kim, Naiyana Praditsitthikorn, Edina Sinanovic, and Raymond Hutubessy "Human papillomavirus vaccine introduction in low-income and middle-income countries: guidance on the use of cost-effectiveness models." <i>BMC Medicine</i> (2011) http://hdl.handle.net/11427/14441 en_ZA
dc.identifier.vancouvercitation Jit M, Demarteau N, Elbasha E, Ginsberg G, Kim J, Praditsitthikorn N, et al. Human papillomavirus vaccine introduction in low-income and middle-income countries: guidance on the use of cost-effectiveness models. BMC Medicine. 2011; http://hdl.handle.net/11427/14441. en_ZA
dc.identifier.ris TY - Journal Article AU - Jit, Mark AU - Demarteau, Nadia AU - Elbasha, Elamin AU - Ginsberg, Gary AU - Kim, Jane AU - Praditsitthikorn, Naiyana AU - Sinanovic, Edina AU - Hutubessy, Raymond AB - BACKGROUND:The World Health Organization (WHO) recommends that the cost effectiveness of introducing human papillomavirus (HPV) vaccination is considered before such a strategy is implemented. However, developing countries often lack the technical capacity to perform and interpret results of economic appraisals of vaccines. To provide information about the feasibility of using such models in a developing country setting, we evaluated models of HPV vaccination in terms of their capacity, requirements, limitations and comparability. METHODS: A 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 standardised data sets representative of two hypothetical developing countries (a low-income country with no screening and a middle-income country with limited screening). Model predictions before and after vaccination of adolescent girls were compared in terms of HPV prevalence and cervical cancer incidence, as was the incremental cost-effectiveness ratio of vaccination under different scenarios. RESULTS: None of the models perfectly reproduced the standardised 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. Apart from the Thai model (in which vaccine and non-vaccine HPV types were combined), vaccine-type HPV prevalence dropped by 75% to 100%, and vaccine-type cervical cancer incidence dropped by 80% to 100% across the models (averaging over age groups). 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. CONCLUSIONS: The results indicated the usefulness of considering results from several models and sets of modelling assumptions in decision making. Modelling groups were prepared to share their models and expertise to work with stakeholders in developing countries.Please see related article: http://www.biomedcentral.com/1741-7007/9/55 DA - 2011 DB - OpenUCT DO - 10.1186/1741-7015-9-54 DP - University of Cape Town J1 - BMC Medicine LK - https://open.uct.ac.za PB - University of Cape Town PY - 2011 T1 - Human papillomavirus vaccine introduction in low-income and middle-income countries: guidance on the use of cost-effectiveness models TI - Human papillomavirus vaccine introduction in low-income and middle-income countries: guidance on the use of cost-effectiveness models UR - http://hdl.handle.net/11427/14441 ER - en_ZA


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