Α systematic review of the cost - effectiveness of the vaccination against HPV
Μία συστηματική ανασκόπηση της βιβλιογραφίας σε μελέτες κόστους – αποτελεσματικότητας του εμβολιασμού ενάντια στον ΗPV
KeywordsΚόστος – αποτελεσματικότητα ; Οικονομική αξιολόγηση ; Εμβόλιο HPV ; Ιός ανθρωπίνων θηλωμάτων
Background: HPV (Human Papillomavirus) is a DNA virus that infects the skin and mucous membranes of humans and is in many cases responsible for the appearance of cancerous or precancerous lesions in many parts of the body. In recent years, vaccines have been integrated into national vaccines in most countries in an effort to combat the virus. There are 3 types of vaccines: Bivalent vaccine targets on HPV types 16, 18 to prevent cervical cancer. Quadrivalent vaccine targets on HPV type 6, 11, 16, 18 to prevent genital warts and cervical cancer. Ninevalent targets on types 6, 11, 16, 18, 31, 33, 45, 52, and 58 which protects from cervical cancer and genital warts too but also anal, vaginal, and vulvar cancer. Methodology: In the recent years many studies have been conducted in order to determine the cost – effectiveness of the vaccines against HPV. The purpose of this work is to collect and analyze all available data from these studies. Another purpose is to find correlations between the various variables that are often present in these studies and identify which factors are more relevant when conducting such studies. A systematic review of the literature was performed through Pubmed and Cochrane Library by using relevant keywords. Specific Inclusion and Exclusion criteria set the boundaries for this systematic review. Results: The search engine identified 264 studies retrieved for evaluation. 235 of those studies were excluded either because their focus was not economic evaluation, or they were already reviews, or they were editorials of HPV vaccination strategies not of interest. A of total 29 studies were included in the review. 12% of them showed that the vaccine is not cost effective and 88% showed that the vaccine is cost effective. Also some of the studied variables have negative or positive effect on the cost – effectiveness analysis. Conclusions: The comparison of different studies using different models cannot lead to deterministic conclusions. Any type of the vaccine should be generally considered cost – effective under certain thresholds. The additional costs of protecting by vaccinating the targeted population through the established screening program would be balanced by the potential savings from not having to treat diseases related to HPV. However, the results should be interpreted with caution. Decision makers must take into account the results, and also reconsider the price of the vaccine as it is΄probably the factor that affects most the cost – effectiveness.