Comparison between Product Characteristics and Decision Analysis Supporting Decision-Makers in Public Health-Related Choices : A Study Model Applied to Anti-HPV Vaccines

Vaccines for the prevention of pathologies caused by Human Papillomavirus (HPV) are undoubtedly considered among the most advanced forms of biotechnological innovation. At present, two different vaccines are available: the bivalent vaccine, targeting the HPV-16 and 18 strains, and the quadrivalent vaccine, which targets the HPV-6, 11, 16 and 18 strains. Observing the impact projections analysis, obtainable on the basis of data published in various studies, it is clear that a reduction of 10.0 euros, resulting from the ex-factory price differential of the two vaccines (in favour of the bivalent) hardly compensate for the considerable increase of the expenditure related to the failure to prevent HPV-induced outcomes, such as abnormal Pap-tests, colposcopies, low and high-grade precancerous lesions, in situ carcinomas, cervical carcinomas, vulvar dysplastic lesions, vaginal dysplastic lesions and genital warts. A mere difference in ex-factory price should not be the only determinant of the vaccine's choice, in the light of the incremental prevention against cervical carcinoma caused by HPV-18 and vulvar carcinoma, and the avoidable risk of onset of genital warts