[Did the recommendation of the French public health council modify the antipapillomavirus vaccines' prescription level?].
BACKGROUND
In France, two vaccines are approved for prevention of papillomavirus infection: Cervarix(®) and Gardasil(®). The 17th of December 2010 the French High Committee of Public Hearth changed its recommendation about Cervarix(®) and decided that no scientific element justified a preference using Gardasil(®). This notification was published the 25th of January 2011. Our study aimed to determine whether this decision changed medical prescriptions.


METHODS
An ecological study was performed with reimbursement data for the two vaccines. We performed a Chi(2) test for qualitative variables and Student's t test for quantitative variables.


RESULTS
A significant difference was observed between the prescription of Cervarix(®) before and after the 25th January 2011. The difference favored increased prescription, compared to Gardasil(®) (P ≤ 0.05).


CONCLUSIONS
This variation can be explained by the impact of recommendations for medical decisions. The strong involvement of pharmaceutical firms in medical education may explain why prescribers reacted so rapidly after the publication of the new recommendations.
Département universitaire de médecine générale, faculté de médecine, 133, route de Narbonne, 31400 Toulouse, France. Electronic address: jordan.birebent@dumg-toulouse.fr.
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J
Birebent
Département universitaire de médecine générale, faculté de médecine, 133, route de Narbonne, 31400 Toulouse, France.
J
J
Dupouy
Département universitaire de médecine générale, faculté de médecine, 133, route de Narbonne, 31400 Toulouse, France.
J
J
Lempégnat
Département universitaire de médecine générale, faculté de médecine, 133, route de Narbonne, 31400 Toulouse, France.
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R
Bourrel
Département universitaire de médecine générale, faculté de médecine, 133, route de Narbonne, 31400 Toulouse, France.
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M
Bismuth
Caisse nationale d'assurance maladie des travailleurs salariés, échelon local Midi-Pyrénées, 3, boulevard Léopold Escande, BP 11503, 31015 Toulouse cedex 9, France.
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Oustric
D000293:Adolescent; D005260:Female; D005602:France / Q000453:epidemiology; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006287:Health Planning Guidelines; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000706:statistics & numerical data / Q000639:trends; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000191:economics / Q000627:therapeutic use*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data* / Q000639:trends; D011635:Public Health Administration / Q000331:legislation & jurisprudence; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control; D014611:Vaccination / Q000191:economics / Q000706:statistics & numerical data / Q000639:trends; D002578:Uterine Cervical Dysplasia / Q000517:prevention & control
D053918:Papillomavirus Vaccines
Antipapillomavirus vaccine; Décision médicale; Medical decisions; Pratiques médicales; Recommandations; Recommendations; Vaccin papillomavirus humains