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.authorJit, Marken_ZA
dc.contributor.authorDemarteau, Nadiaen_ZA
dc.contributor.authorElbasha, Elaminen_ZA
dc.contributor.authorGinsberg, Garyen_ZA
dc.contributor.authorKim, Janeen_ZA
dc.contributor.authorPraditsitthikorn, Naiyanaen_ZA
dc.contributor.authorSinanovic, Edinaen_ZA
dc.contributor.authorHutubessy, Raymonden_ZA
dc.date.accessioned2015-10-28T06:55:09Z
dc.date.available2015-10-28T06:55:09Z
dc.date.issued2011en_ZA
dc.description.abstractBACKGROUND: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/1741-7007/9/55en_ZA
dc.identifier.apacitationJit, 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/11427/14441en_ZA
dc.identifier.chicagocitationJit, 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/11427/14441en_ZA
dc.identifier.citationJit, 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.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
dc.identifier.urihttp://hdl.handle.net/11427/14441
dc.identifier.urihttp://dx.doi.org/10.1186/1741-7015-9-54
dc.identifier.vancouvercitationJit 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.language.isoengen_ZA
dc.publisherBioMed Central Ltden_ZA
dc.publisher.departmentHealth Economics Uniten_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution Licenseen_ZA
dc.rights.holder2011 World Health Organization; licensee BioMed Central Ltd.en_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/2.0en_ZA
dc.sourceBMC Medicineen_ZA
dc.source.urihttp://www.biomedcentral.com/bmcmed/en_ZA
dc.subject.otherCost-Benefit Analysisen_ZA
dc.subject.otherModels, Statisticalen_ZA
dc.subject.otherPapillomavirus Infectionsen_ZA
dc.subject.otherPapillomavirus Vaccinesen_ZA
dc.subject.otherUterine Cervical Neoplasmsen_ZA
dc.titleHuman papillomavirus vaccine introduction in low-income and middle-income countries: guidance on the use of cost-effectiveness modelsen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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