Economic evaluation of human papilloma virus vaccination in the European Union: a critical reviewArchived
The authors performed a literature review of all economic evaluations (EEs) of HPV vaccines conducted in EU countries and published in English from January 2007 to June 2010. EEs were classified and compared according to their model, the economic variables used, the modelling techniques and whether or not they had financial backing from vaccine manufacturers.
Daniela Koleva, Paola De Compadri, Anna Padula, Livio Garattini. Intern Emerg Med. 2011 Feb 11. [Epub ahead of print]
The authors performed a literature review of all economic evaluations (EEs) of HPV vaccines conducted in EU countries and published in English from January 2007 to June 2010. EEs were classified and compared according to their model, the economic variables used, the modelling techniques and whether or not they had financial backing from vaccine manufacturers.
15 articles (comprising 24 EEs) were selected: 18 EEs specifically assessing the quadrivalent or the bivalent vaccine, all funded by their respective manufacturers, and 6 EEs unrelated to the type of vaccine, all funded by public agencies.
Unrealistic and optimistic estimates of crucial variables are used in most of the articles: use of vaccine effectiveness against HPV infection rather than against HPV associated cervical lesions, assumption of very high vaccine coverage and cervical screening rates, adoption of American utility scores for cost utility analysis instead of validated European scales, use of manufacturer’s price instead of price to the public. Public and manufacturer’s funded studies do not significantly differ in methodology and findings, except for general overemphasis by the latter of positive results with the vaccine strategy. The authors conclude that there is subjectivity in key assumptions and methodological choices that makes these EEs not very useful for public policy purposes.