title: The Australian funding debate on quadrivalent HPV vaccine: a case study for the national pharmaceutical policy.
abstract: OBJECTIVE
  To analyse the media and political reactions to the initial decision of the Pharmaceutical Benefits Advisory Committee (PBAC) to reject funding of the quadrivalent human papilloma virus (HPV) vaccine in Australia.
  
  
  METHODS
  A case study, informed by media reports and government documents, was utilised to examine the reactions of key stakeholders; PBAC, consumers, consumer organisations, pharmaceutical industry, politicians, health professionals and the media to the initial decision to reject funding of HPV vaccine.
  
  
  RESULTS
  The initial decision to reject funding of the HPV vaccine led to unprecedented public response with over 300 newspaper articles and calls by consumers, health professionals and politicians to intervene in the decision making process. Misunderstanding of the decision making process, particularly cost-effectiveness assessments, the need for an independent process, the legislated inability of a timely and transparent response from policy makers and the lack of a risk mitigation strategy all played a role in the public outcry.
  
  
  CONCLUSIONS
  Despite 15 years of implementation of cost-effectiveness assessments there is still a need for improving stakeholder understanding of the decision making process and for timely transfer of complete information. Risk mitigation strategies should be considered as part of the communication plan for all decisions.
authors.affiliation: Quality Use of Medicines and Pharmacy Practice Research Centre, Sansom Institute, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia. libby.roughead@unisa.edu.au
authors.forename: Elizabeth Ellen
authors.initials: EE
authors.lastname: Roughead
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Gilbert
authors.forename: Agnes I
authors.initials: AI
authors.lastname: Vitry
mesh_terms: D001315:Australia; D003362:Cost-Benefit Analysis; D004335:Drug and Narcotic Control; D005378:Financial Support; D009313:National Health Programs; D019982:Organizational Case Studies; D030361:Papillomavirus Infections / Q000517:prevention & control; D053918:Papillomavirus Vaccines / Q000191:economics*; D040841:Resource Allocation
chemical_list: D053918:Papillomavirus Vaccines