title: The human papillomavirus vaccination: a review of the cost-effectiveness studies.
abstract: BACKGROUND
  The Human Papillomavirus (HPV) is one of the most common sexually transmitted viruses, its infection with certain subtypes is the primary cause of cervical cancer. Several countries conducted specific cost-effectiveness evaluations toward HPV vaccination. The constant growth of healthcare demand, in an economic context characterized by limited resources, requires that the decision-making process be based on the comparison of alternative choices. This study offers an overview of the published cost-effectiveness studies about HPV vaccination.
  The research was performed on the scientific databases MEDLINE and SCOPUS in order to find out journal articles focused on cost-effectiveness of the HPV vaccination. The rational for any exclusion criteria of data in the search is mainly due to lack of relevance to cost-effectiveness information.
  
  
  RESULTS
  The literature results were presented according to different groups of countries worldwide. A total of 24 articles were finally retrieved. In spite of the different models and assumptions, most studies showed the cost-effectiveness of vaccination; only two studies considered the vaccination as not cost effective.
  
  
  CONCLUSIONS
  HPV vaccination may determine a cost reduction for country-specific National Health Systems. However, the cost-effectiveness of universal HPV vaccination still remains an open debate. It is important that economic analysis of universal HPV vaccination adopts large perspectives than is the case with the existing literature, focusing on the critical issues that still exist in many areas. Reducing cost, increasing duration of efficacy, and integrating vaccines into existing screening and treatment procedures in a cost-effective manner are of crucial importance even as they are a major challenge.
authors.affiliation: Departments of Public Health and Infectious Diseases, Sapienza University of Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Giraldi
authors.affiliation: Departments of Physiology and Pharmacology "V. Erspamer" University of Rome, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Martinoli
authors.affiliation: Departments of Public Health and Infectious Diseases, Sapienza University of Rome, Italy.
authors.forename: E
authors.initials: E
authors.lastname: De Luca d'Alessandro
mesh_terms: D003362:Cost-Benefit Analysis; D006801:Humans; D032541:Mass Vaccination / Q000191:economics; D009369:Neoplasms / Q000517:prevention & control / Q000821:virology; D053918:Papillomavirus Vaccines / Q000191:economics* / Q000627:therapeutic use*
chemical_list: D053918:Papillomavirus Vaccines
keywords: Cervical cancer; Cost-effectiveness; Decision-makers; HPV vaccination; Human Papillomavirus; Prevention