A brief history of economic evaluation for human papillomavirus vaccination policy.
BACKGROUND
This commentary discusses key issues for health economic evaluation and modelling, applied to human papillomavirus (HPV) vaccine programs.


METHODS
We outline some of the specific features of HPV disease and vaccination, and associated policy questions in light of a literature search for economic evaluations on HPV vaccination.


RESULTS
We observe that some policy questions could not be reliably addressed by many of the 43 published economic evaluations we found. Despite this, policy making on universal HPV vaccination followed shortly after vaccine licensure in many developed countries, so the role economic evaluation played in informing these decisions (pre-dating 2008) seems to have been fairly limited. For more recent decisions, however, economic evaluation is likely to have been used more widely and more intensively.


CONCLUSIONS
We expect future cost-effectiveness analyses to be more instrumental in policy making regarding vaccines covering more HPV types, therapeutic HPV vaccines, and novel diagnostic tests for biomarkers of HPV infection and disease integrated with cervical screening programs.
Beutels
Philippe
P
Centre for Health Economics Research and Modeling Infectious Diseases, University of Antwerp, Antwerp 2610, Belgium. philippe.beutels@ua.ac.be
Jit
Mark
M
D000293:Adolescent; D000328:Adult; D002648:Child; D003218:Condylomata Acuminata / Q000191:economics* / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D005060:Europe; D005260:Female; D006291:Health Policy / Q000191:economics; D000068857:Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18; D006801:Humans; D008297:Male; D032541:Mass Vaccination / Q000191:economics*; D018803:Models, Economic; D030361:Papillomavirus Infections / Q000191:economics* / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage* / Q000191:economics*; D011639:Public Opinion; D019057:Quality-Adjusted Life Years; D015229:Sexually Transmitted Diseases, Viral / Q000191:economics* / Q000517:prevention & control*; D002583:Uterine Cervical Neoplasms / Q000191:economics* / Q000517:prevention & control*; D055815:Young Adult
D000068857:Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18; D053918:Papillomavirus Vaccines; C510352:human papillomavirus vaccine, L1 type 16, 18