title: Governance of preventive Health Intervention and On time Verification of its Efficiency: the GIOVE Study.
abstract: OBJECTIVE
  The GIOVE Study was aimed to the achievement of allocative efficiency of the budget allocated to the prevention of human papillomavirus (HPV)-induced diseases. An ex-ante determination of the most efficient allocation of resources between screening and multicohort quadrivalent immunisation programmes was followed by the ex-post assessment of the allocative efficiency actually achieved after a 12-month period.
  
  
  METHODS
  A bound optimisation model was developed to determine the ex-ante allocative efficiency of resources. The alternatives compared were the screening programme alone and the quadrivalent immunisation with access to screening. A sensitivity analysis was carried out to assess the uncertainty associated with the main inputs of the model. Subsequently, a cohort of girls with a complete recorded vaccination history were enrolled in an observational retrospective study for 18 months to ensure full compliance with the recommended schedule of vaccination (0, 2, 6 months) within a 12-month time horizon.
  
  
  METHODS
  Basilicata region, in the south of Italy.
  
  
  METHODS
  12 848 girls aged 12, 15, 18 or 25 years.
  
  
  METHODS
  Immunisation with quadrivalent anti-HPV vaccine.
  
  
  METHODS
  The vaccination coverage rate was considered to be the indicator of the best achievable benefit, given the budgetary constraints.
  
  
  RESULTS
  Assuming a vaccine price of €100 per dose, a vaccination coverage rate of 59.6% was required for the most effective allocation of resources. The optimal rate of coverage was initially in favour of the multicohort strategy of vaccination against HPV (72.8%±2%). When the price paid for the quadrivalent vaccine dropped to €85 per dose, the most efficient coverage rate (69.5%) shifted closer to the immunisation rate actually achieved during the 12-month observation period.
  
  
  CONCLUSIONS
  The bound optimisation model demonstrated to be a useful approach to the ex-ante allocation and the ex-post assessment of the resources allocated to the implementation of a multicohort quadrivalent anti-HPV vaccination programme.
authors.affiliation: CEIS Sanità-Centre for Health Economics and Management (CHEM), Faculty of Economics, Tor Vergata University, Rome, Italy.
authors.forename: Francesco Saverio
authors.initials: FS
authors.lastname: Mennini
authors.forename: Gianluca
authors.initials: G
authors.lastname: Baio
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Montagano
authors.forename: Gabriella
authors.initials: G
authors.lastname: Cauzillo
authors.forename: Francesco
authors.initials: F
authors.lastname: Locuratolo
authors.forename: Gerardo
authors.initials: G
authors.lastname: Becce
authors.forename: Lara
authors.initials: L
authors.lastname: Gitto
authors.forename: Andrea
authors.initials: A
authors.lastname: Marcellusi
authors.forename: Peter
authors.initials: P
authors.lastname: Zweifel
authors.forename: Alessandro
authors.initials: A
authors.lastname: Capone
authors.forename: Giampiero
authors.initials: G
authors.lastname: Favato