title: The cost effectiveness of human papillomavirus vaccines: a systematic review.
abstract: BACKGROUND
  Human papillomavirus (HPV) is one of the world's most common sexually transmitted infections, and has been associated with a number of cervical and non-cervical diseases, including cancer. HPV vaccines have been licensed for use in females for some time, but the quadrivalent vaccine has only recently become licensed for use in males. Many countries have adopted a vaccination programme for adolescent females based on results of cost-effectiveness analyses. However, given the new indications for use of the vaccine in males, decision makers require information on the cost effectiveness of vaccinating males in order to make policy decisions on whether or not to fund such programmes.
  
  
  OBJECTIVE
  Our objective was to conduct a qualitative systematic review to update a previously conducted review of HPV vaccine studies.
  
  
  METHODS
  Articles were obtained from an extensive literature search to determine the cost effectiveness of implementing an HPV vaccination programme with routine cervical cancer screening. A total of 29 studies were included in this review. Seventeen of the included articles looked only at cervical disease outcomes, and 12 studies also included non-cervical disease outcomes. Four studies explored the economic impact of vaccinating both boys and girls. One study focused on a population of men who have sex with men (MSM).
  
  
  RESULTS
  While different model structures, input parameters and baseline assumptions were used, the consistent message in studies that focused on female-only vaccination programmes was that routine vaccination of females is cost effective compared with cervical cancer screening alone.
  
  
  CONCLUSIONS
  Based on the currently available literature, it appears that the addition of boys to a vaccination programme generally exceeds traditional cost-effectiveness thresholds. The MSM population represents a potential additional target for routine HPV vaccination; however, more cost-effectiveness studies are required before making such a policy change.
authors.affiliation: Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Katherine
authors.initials: K
authors.lastname: Seto
authors.forename: Fawziah
authors.initials: F
authors.lastname: Marra
authors.forename: Adam
authors.initials: A
authors.lastname: Raymakers
authors.forename: Carlo A
authors.initials: CA
authors.lastname: Marra
mesh_terms: D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D018803:Models, Economic; D030361:Papillomavirus Infections / Q000276:immunology / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000191:economics* / Q000276:immunology; D016032:Randomized Controlled Trials as Topic; D002583:Uterine Cervical Neoplasms / Q000276:immunology / Q000517:prevention & control*
chemical_list: D053918:Papillomavirus Vaccines