Open Access Correspondence

Economic analyses to support decisions about HPV vaccination in low- and middle-income countries: a consensus report and guide for analysts

Mark Jit12, Carol Levin3, Marc Brisson45, Ann Levin6, Stephen Resch7, Johannes Berkhof8, Jane Kim7 and Raymond Hutubessy9*

Author affiliations

1 Modelling and Economics Unit, Health Protection Agency, 61 Colindale Avenue, London NW9 5EQ, UK

2 Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK

3 PATH, 2201 Westlake Avenue, Suite 200 Seattle, WA 98121 USA

4 Centre de recherche du CHU de Québec, Hôpital Saint-Sacrement, 1050 Chemin Sainte-Foy, Québec, G1S 4L8, Canada

5 Department of Infectious Disease Epidemiology, Imperial College, London, UK

6 Independent Consultant, 6414 Hollins Dr., Bethesda, MD 20817 USA

7 Center for Health Decision Science, Harvard School of Public Health, 718 Huntington Ave, Boston, MA 02130, USA

8 Department of Epidemiology and Biostatistics, VU University Medical Centre, PO box 7057, 1007 MB Amsterdam, The Netherlands

9 Initiative for Vaccine Research, World Health Organization, 20 Avenue Appia, CH-1211 Geneva, Switzerland

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Citation and License

BMC Medicine 2013, 11:23  doi:10.1186/1741-7015-11-23

Published: 30 January 2013


Low- and middle-income countries need to consider economic issues such as cost-effectiveness, affordability and sustainability before introducing a program for human papillomavirus (HPV) vaccination. However, many such countries lack the technical capacity and data to conduct their own analyses. Analysts informing policy decisions should address the following questions: 1) Is an economic analysis needed? 2) Should analyses address costs, epidemiological outcomes, or both? 3) If costs are considered, what sort of analysis is needed? 4) If outcomes are considered, what sort of model should be used? 5) How complex should the analysis be? 6) How should uncertainty be captured? 7) How should model results be communicated? Selecting the appropriate analysis is essential to ensure that all the important features of the decision problem are correctly represented, but that the analyses are not more complex than necessary. This report describes the consensus of an expert group convened by the World Health Organization, prioritizing key issues to be addressed when considering economic analyses to support HPV vaccine introduction in these countries.

Human papillomavirus; vaccination; low- and middle-income countries; economic evaluation.