Skip to main content
Erschienen in: PharmacoEconomics 2/2009

01.02.2009 | Review Article

Effectiveness and Cost Effectiveness of Human Papillomavirus Vaccine

A Systematic Review

verfasst von: Dr Fawziah Marra, Karine Cloutier, Bridgette Oteng, Carlo Marra, Gina Ogilvie

Erschienen in: PharmacoEconomics | Ausgabe 2/2009

Einloggen, um Zugang zu erhalten

Abstract

The recent approval of human papillomavirus (HPV) vaccine means that decision makers need information beyond that available from randomized clinical trials to recommend funding for this vaccination programme. Modelling and economic studies have addressed some of those information needs. We conducted a qualitative systematic review to summarize the existing data. Review articles were obtained from an extensive literature search on studies using mathematical modelling (either a Markov or transmission dynamic model) to determine the effectiveness or cost effectiveness of an HPV vaccine compared with the current cytology-based Pap smear screening programme.
A total of 21 studies (but 22 models) were included in the review after being assessed for methodological quality. All of the included studies had used a mathematical model to determine the effectiveness of an HPV vaccine, whilst 13 had also conducted a cost-effectiveness analysis. Although the studies used different model structures, baseline parameters and assumptions, all studies showed that vaccination would decrease rates of HPV infection, precancerous lesions and cervical cancer. Studies had a consistent message with respect to cost effectiveness: a female-only vaccination programme is cost effective compared with the current cytology-based Pap smear screening programme, while the cost effectiveness of a male and female vaccination programme is generally not cost effective compared with female-only vaccination.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Bosch FX, Lorincz A, Muñoz N, et al. The causal relation between human papillomavirus and cervical cancer. J Clin Pathol 2002; 55: 244–65PubMedCrossRef Bosch FX, Lorincz A, Muñoz N, et al. The causal relation between human papillomavirus and cervical cancer. J Clin Pathol 2002; 55: 244–65PubMedCrossRef
2.
Zurück zum Zitat Goodman A. Primary vaginal cancer. Surg Oncol Clin N Am 1998; 7: 347–61PubMed Goodman A. Primary vaginal cancer. Surg Oncol Clin N Am 1998; 7: 347–61PubMed
3.
Zurück zum Zitat Jones RW, Rowan DM, Stewart AW. Vulvar intraepithelial neoplasia: aspects of the natural history and outcome in 405 women. Obstet Gynecol 2005; 106: 1319–26PubMedCrossRef Jones RW, Rowan DM, Stewart AW. Vulvar intraepithelial neoplasia: aspects of the natural history and outcome in 405 women. Obstet Gynecol 2005; 106: 1319–26PubMedCrossRef
4.
Zurück zum Zitat Dianzani C, Calvieri S, Pierangeli A, et al. Identification of human papilloma viruses in male dysplastic genital lesions. New Microbiol 2004; 27: 65–9PubMed Dianzani C, Calvieri S, Pierangeli A, et al. Identification of human papilloma viruses in male dysplastic genital lesions. New Microbiol 2004; 27: 65–9PubMed
5.
Zurück zum Zitat McKaig RG, Baric RS, Olshan AF. Human papillomavirus and head and neck cancer: epidemiology and molecular biology. Head Neck 1998; 20: 250–65PubMedCrossRef McKaig RG, Baric RS, Olshan AF. Human papillomavirus and head and neck cancer: epidemiology and molecular biology. Head Neck 1998; 20: 250–65PubMedCrossRef
6.
Zurück zum Zitat Greer CE, Wheeler CM, Ladner MB, et al. Human papillomavirus (HPV) type distribution and serological response to HPV type 6 virus-like particles in patients with genital warts. J Clin Microbiol 1995; 33: 2058–63PubMed Greer CE, Wheeler CM, Ladner MB, et al. Human papillomavirus (HPV) type distribution and serological response to HPV type 6 virus-like particles in patients with genital warts. J Clin Microbiol 1995; 33: 2058–63PubMed
7.
Zurück zum Zitat Derkay CS, Darrow DH. Recurrent respiratory papillomatosis of the larynx: current diagnosis and treatment. Otolaryngol Clin North Am 2000; 33: 1127–42PubMedCrossRef Derkay CS, Darrow DH. Recurrent respiratory papillomatosis of the larynx: current diagnosis and treatment. Otolaryngol Clin North Am 2000; 33: 1127–42PubMedCrossRef
8.
Zurück zum Zitat Parkin DM. The global health burden of infection-associated cancers in the year 2002. Int J Cancer 2006; 118: 3030–44 Parkin DM. The global health burden of infection-associated cancers in the year 2002. Int J Cancer 2006; 118: 3030–44
9.
Zurück zum Zitat Ferlay J, Bray F, Pisani P, et al. GLOBOCAN 2002. Cancer incidence, mortality and prevalence worldwide. IARC CancerBase No.5, Version 2.0. Lyon: IARC Press, 2004 Ferlay J, Bray F, Pisani P, et al. GLOBOCAN 2002. Cancer incidence, mortality and prevalence worldwide. IARC CancerBase No.5, Version 2.0. Lyon: IARC Press, 2004
10.
Zurück zum Zitat Muñoz N, Bosch FX, De Sanjosé S, et al., International Agency for Research on Cancer Multicenter Cervical Cancer Study Group. Epidemiologic classification of human papillomavirus types associated with cervical cancer. N Engl J Med 2003; 348: 518–27PubMedCrossRef Muñoz N, Bosch FX, De Sanjosé S, et al., International Agency for Research on Cancer Multicenter Cervical Cancer Study Group. Epidemiologic classification of human papillomavirus types associated with cervical cancer. N Engl J Med 2003; 348: 518–27PubMedCrossRef
13.
Zurück zum Zitat Koutsky LA, Ault KA, Wheeler CM, et al. A controlled trial of a human papillomavirus type 16 vaccine. N Engl J Med 2002; 347: 1645–51PubMedCrossRef Koutsky LA, Ault KA, Wheeler CM, et al. A controlled trial of a human papillomavirus type 16 vaccine. N Engl J Med 2002; 347: 1645–51PubMedCrossRef
14.
Zurück zum Zitat Mao C, Koutsky LA, Ault KA, et al. Efficacy of human papillomavirus-16 vaccine to prevent cervical intraepithelial neoplasia: a randomized controlled trial. Obstet Gynecol 2006; 107: 18–27PubMedCrossRef Mao C, Koutsky LA, Ault KA, et al. Efficacy of human papillomavirus-16 vaccine to prevent cervical intraepithelial neoplasia: a randomized controlled trial. Obstet Gynecol 2006; 107: 18–27PubMedCrossRef
15.
Zurück zum Zitat Villa LL, Costa RL, Petta CA, et al. Prophylactic quadrivalent human papillomavirus (types 6, 11, 16, and 18) L1 virus-like particle vaccine in young women: a randomised double-blind placebo-controlled multicentre phase II efficacy trial. Lancet Oncol 2005; 6: 271–8PubMedCrossRef Villa LL, Costa RL, Petta CA, et al. Prophylactic quadrivalent human papillomavirus (types 6, 11, 16, and 18) L1 virus-like particle vaccine in young women: a randomised double-blind placebo-controlled multicentre phase II efficacy trial. Lancet Oncol 2005; 6: 271–8PubMedCrossRef
16.
Zurück zum Zitat Villa LL, Ault KA, Giuliano AR, et al. Immunologic responses following administration of a vaccine targeting human papillomavirus types 6, 11, 16, and 18. Vaccine 2006; 24: 5571–83PubMedCrossRef Villa LL, Ault KA, Giuliano AR, et al. Immunologic responses following administration of a vaccine targeting human papillomavirus types 6, 11, 16, and 18. Vaccine 2006; 24: 5571–83PubMedCrossRef
17.
Zurück zum Zitat Villa LL, Costa RL, Petta CA, et al. High sustained efficacy of a prophylactic quadrivalent human papillomavirus types 6/11/16/18 L1 virus-like particle vaccine through 5 years of follow-up. Br J Cancer 2006; 95: 1459–66PubMedCrossRef Villa LL, Costa RL, Petta CA, et al. High sustained efficacy of a prophylactic quadrivalent human papillomavirus types 6/11/16/18 L1 virus-like particle vaccine through 5 years of follow-up. Br J Cancer 2006; 95: 1459–66PubMedCrossRef
18.
Zurück zum Zitat Harper DM, Franco EL, Wheeler CM, et al., HPV Vaccine Study group. Sustained efficacy up to 4.5 years of a bivalent L1 virus-like particle vaccine against human papillomavirus types 16 and 18: follow-up from a randomised control trial. Lancet 2006; 367: 1247–55PubMedCrossRef Harper DM, Franco EL, Wheeler CM, et al., HPV Vaccine Study group. Sustained efficacy up to 4.5 years of a bivalent L1 virus-like particle vaccine against human papillomavirus types 16 and 18: follow-up from a randomised control trial. Lancet 2006; 367: 1247–55PubMedCrossRef
19.
Zurück zum Zitat Harper DM, Franco EL, Wheeler C, et al., GlaxoSmithKline HPV Vaccine Study Group. Efficacy of a bivalent L1 virus-like particle vaccine in prevention of infection with human papillomavirus types 16 and 18 in young women: a randomised controlled trial. Lancet 2004; 364: 1757–65PubMedCrossRef Harper DM, Franco EL, Wheeler C, et al., GlaxoSmithKline HPV Vaccine Study Group. Efficacy of a bivalent L1 virus-like particle vaccine in prevention of infection with human papillomavirus types 16 and 18 in young women: a randomised controlled trial. Lancet 2004; 364: 1757–65PubMedCrossRef
20.
Zurück zum Zitat Barr E, Tamms G. Quadrivalent human papillomavirus vaccine. Clin Infect Dis 2007; 45 (5): 609–7PubMedCrossRef Barr E, Tamms G. Quadrivalent human papillomavirus vaccine. Clin Infect Dis 2007; 45 (5): 609–7PubMedCrossRef
21.
Zurück zum Zitat Garnett GP, Kim JJ, French K, et al. Chapter 21: modelling the impact of HPV vaccines on cervical cancer and screening programmes. Vaccine 2006; 24 Suppl. 3: S178–86CrossRef Garnett GP, Kim JJ, French K, et al. Chapter 21: modelling the impact of HPV vaccines on cervical cancer and screening programmes. Vaccine 2006; 24 Suppl. 3: S178–86CrossRef
22.
Zurück zum Zitat Dasbach EJ, Elbasha EH, Insinga RP. Mathematical models for predicting the epidemiologic and economic impact of vaccination against human papillomavirus infection and disease. Epidemiol Rev 2006; 28: 88–100PubMedCrossRef Dasbach EJ, Elbasha EH, Insinga RP. Mathematical models for predicting the epidemiologic and economic impact of vaccination against human papillomavirus infection and disease. Epidemiol Rev 2006; 28: 88–100PubMedCrossRef
23.
Zurück zum Zitat Newall AT, Beutels P, Wood JG, et al. Cost-effectiveness analyses of human papillomavirus vaccination. Lancet Infect Dis 2007; 7: 289–96PubMedCrossRef Newall AT, Beutels P, Wood JG, et al. Cost-effectiveness analyses of human papillomavirus vaccination. Lancet Infect Dis 2007; 7: 289–96PubMedCrossRef
24.
Zurück zum Zitat Goldie S, Goldhaber-Fiebert JD, Garnett GP. Chapter 18: public health policy for cervical cancer prevention. The role of decision science, economic evaluation, and mathematical modeling. Vaccine 2006; 24 Suppl 3: S155–63CrossRef Goldie S, Goldhaber-Fiebert JD, Garnett GP. Chapter 18: public health policy for cervical cancer prevention. The role of decision science, economic evaluation, and mathematical modeling. Vaccine 2006; 24 Suppl 3: S155–63CrossRef
25.
Zurück zum Zitat Drummond MF, Richardson WS, O’Brien BJ, et al. User’s guides to the medical literature: XII. How to use an article on economic analysis of clinical practice: A. Are the results of study valid? JAMA 1997; 207 (19): 1552–7CrossRef Drummond MF, Richardson WS, O’Brien BJ, et al. User’s guides to the medical literature: XII. How to use an article on economic analysis of clinical practice: A. Are the results of study valid? JAMA 1997; 207 (19): 1552–7CrossRef
26.
Zurück zum Zitat Hughes JP, Garnett GP, Koutsky L. The theoretical population-level impact of a prophylactic human papilloma virus vaccine. Epidemiology 2002; 13: 631–9PubMedCrossRef Hughes JP, Garnett GP, Koutsky L. The theoretical population-level impact of a prophylactic human papilloma virus vaccine. Epidemiology 2002; 13: 631–9PubMedCrossRef
27.
Zurück zum Zitat Sanders GD, Taira AV. Cost effectiveness of a potential vaccine for human papillomavirus. Emerg Infect Dis 2003; 9: 37–48PubMedCrossRef Sanders GD, Taira AV. Cost effectiveness of a potential vaccine for human papillomavirus. Emerg Infect Dis 2003; 9: 37–48PubMedCrossRef
28.
Zurück zum Zitat Kulasingam SL, Myers ER. Potential health and economic impact of adding human papillomavirus vaccine to screening programs. JAMA 2003; 290: 781–9PubMedCrossRef Kulasingam SL, Myers ER. Potential health and economic impact of adding human papillomavirus vaccine to screening programs. JAMA 2003; 290: 781–9PubMedCrossRef
29.
Zurück zum Zitat Goldie SJ, Grima D, Kohli M, et al. A comprehensive natural history model of HPV infection and cervical cancer to estimate the clinical impact of a prophylactic HPV-16/18 vaccine. Int J Cancer 2003; 106: 896–904PubMedCrossRef Goldie SJ, Grima D, Kohli M, et al. A comprehensive natural history model of HPV infection and cervical cancer to estimate the clinical impact of a prophylactic HPV-16/18 vaccine. Int J Cancer 2003; 106: 896–904PubMedCrossRef
30.
Zurück zum Zitat Goldie SJ, Kohli M, Grima D, et al. Projected clinical benefits and cost-effectiveness of a human papillomavirus 16/18 vaccine. J Natl Cancer Inst 2004; 96: 604–15PubMedCrossRef Goldie SJ, Kohli M, Grima D, et al. Projected clinical benefits and cost-effectiveness of a human papillomavirus 16/18 vaccine. J Natl Cancer Inst 2004; 96: 604–15PubMedCrossRef
31.
Zurück zum Zitat Kohli M, Ferko N, Martin A, et al. Estimating the long-term impact of a prophylactic human papillomavirus 16/18 vaccine on the burden of cervical cancer in the UK. Br J Cancer 2007; 96: 143–50PubMedCrossRef Kohli M, Ferko N, Martin A, et al. Estimating the long-term impact of a prophylactic human papillomavirus 16/18 vaccine on the burden of cervical cancer in the UK. Br J Cancer 2007; 96: 143–50PubMedCrossRef
33.
Zurück zum Zitat Brisson M, Van de Velde N, De Wals P, et al. The potential cost-effectiveness of prophylactic human papillomavirus vaccines in Canada. Vaccine 2007; 25: 5399–408PubMedCrossRef Brisson M, Van de Velde N, De Wals P, et al. The potential cost-effectiveness of prophylactic human papillomavirus vaccines in Canada. Vaccine 2007; 25: 5399–408PubMedCrossRef
34.
Zurück zum Zitat Kulasingam S, Connelly L, Conway E, et al. A cost-effectiveness analysis of adding a human papillomavirus vaccine to the Australian National Cervical Cancer Screening Program. Sexual Health 2007; 4: 165–75PubMedCrossRef Kulasingam S, Connelly L, Conway E, et al. A cost-effectiveness analysis of adding a human papillomavirus vaccine to the Australian National Cervical Cancer Screening Program. Sexual Health 2007; 4: 165–75PubMedCrossRef
35.
Zurück zum Zitat Kulasingam SL, Benard S, Barnabas RV, et al. Adding a quadrivalent human papillomavirus vaccine to the UK cervical cancer screening programme: a cost-effectiveness analysis. Cost Eff Resour Alloc 2008; 6 (1): 4–15PubMedCrossRef Kulasingam SL, Benard S, Barnabas RV, et al. Adding a quadrivalent human papillomavirus vaccine to the UK cervical cancer screening programme: a cost-effectiveness analysis. Cost Eff Resour Alloc 2008; 6 (1): 4–15PubMedCrossRef
36.
Zurück zum Zitat Bergeron C, Largeron N, McAllister R, et al. Cost-effectiveness analysis of the introduction of a quadrivalent human papillomavirus vaccine in France. Int J Technol Assess Health Care 2008; 24 (1): 10–9PubMedCrossRef Bergeron C, Largeron N, McAllister R, et al. Cost-effectiveness analysis of the introduction of a quadrivalent human papillomavirus vaccine in France. Int J Technol Assess Health Care 2008; 24 (1): 10–9PubMedCrossRef
37.
Zurück zum Zitat Taira AV, Neukermans CP, Sanders GD. Evaluating human papillomavirus vaccination programs. Emerg Infect Dis 2004; 10: 1915–23PubMedCrossRef Taira AV, Neukermans CP, Sanders GD. Evaluating human papillomavirus vaccination programs. Emerg Infect Dis 2004; 10: 1915–23PubMedCrossRef
38.
Zurück zum Zitat Barnabas RV, Laukkanen P, Koskela P, et al. Epidemiology of HPV 16 and cervical cancer in Finland and the potential impact of vaccination: mathematical modelling analyses. PLoS Med 2006; 3: e138 Barnabas RV, Laukkanen P, Koskela P, et al. Epidemiology of HPV 16 and cervical cancer in Finland and the potential impact of vaccination: mathematical modelling analyses. PLoS Med 2006; 3: e138
39.
Zurück zum Zitat French KM, Barnabas RV, Lehtinen M, et al. Strategies for the introduction of human papillomavirus vaccination: modelling the optimum age- and sex-specific pattern of vaccination in Finland. Br J Cancer 2007; 96: 514–8PubMedCrossRef French KM, Barnabas RV, Lehtinen M, et al. Strategies for the introduction of human papillomavirus vaccination: modelling the optimum age- and sex-specific pattern of vaccination in Finland. Br J Cancer 2007; 96: 514–8PubMedCrossRef
40.
Zurück zum Zitat Elbasha EH, Dasbach EJ, Insinga RP. Model for assessing human papillomavirus vaccination strategies. Emerg Infect Dis 2007; 13: 28–41PubMedCrossRef Elbasha EH, Dasbach EJ, Insinga RP. Model for assessing human papillomavirus vaccination strategies. Emerg Infect Dis 2007; 13: 28–41PubMedCrossRef
41.
Zurück zum Zitat Günther OP, Ogilvie G, Naus M, et al. Protecting the next generation: what is the role of the duration of human papillomavirus vaccine-related immunity? J Infect Dis 2008; 197 (12): 1653–61PubMedCrossRef Günther OP, Ogilvie G, Naus M, et al. Protecting the next generation: what is the role of the duration of human papillomavirus vaccine-related immunity? J Infect Dis 2008; 197 (12): 1653–61PubMedCrossRef
43.
Zurück zum Zitat Insinga RP, Dasbach EJ, Elbasha EH, et al. Cost-effectiveness of quadrivalent human papillomavirus (HPV) in Mexico: a transmission dynamic model-based evaluation. Vaccine 2007; 26: 128–39PubMedCrossRef Insinga RP, Dasbach EJ, Elbasha EH, et al. Cost-effectiveness of quadrivalent human papillomavirus (HPV) in Mexico: a transmission dynamic model-based evaluation. Vaccine 2007; 26: 128–39PubMedCrossRef
44.
Zurück zum Zitat Regan DG, Philp DJ, Hocking JS, et al. Modelling the population-level impact of vaccination on the transmission of human papillomavirus type 16 in Australia. Sexual Health 2007; 4: 147–63PubMedCrossRef Regan DG, Philp DJ, Hocking JS, et al. Modelling the population-level impact of vaccination on the transmission of human papillomavirus type 16 in Australia. Sexual Health 2007; 4: 147–63PubMedCrossRef
45.
Zurück zum Zitat Kim JJ, Andres-Beck B, Goldie SJ. The value of including boys in an HPV vaccination programme: a cost-effectiveness analysis in a low-resource setting. Br J Cancer 2007; 97: 1322–8PubMedCrossRef Kim JJ, Andres-Beck B, Goldie SJ. The value of including boys in an HPV vaccination programme: a cost-effectiveness analysis in a low-resource setting. Br J Cancer 2007; 97: 1322–8PubMedCrossRef
49.
Zurück zum Zitat Goldie SJ, Kim JJ, Kobus K, et al. Cost-effectiveness of HPV 16, 18 vaccination in Brazil. Vaccine 2007 Aug 14; 25 (33): 6257–70PubMedCrossRef Goldie SJ, Kim JJ, Kobus K, et al. Cost-effectiveness of HPV 16, 18 vaccination in Brazil. Vaccine 2007 Aug 14; 25 (33): 6257–70PubMedCrossRef
50.
Zurück zum Zitat Yang BH, Bray FI, Parkin DM, et al. Cervical cancer as a priority for prevention in different world regions: an evaluation using years of life lost. Int J Cancer 2004; 109 (3): 418–24.PubMedCrossRef Yang BH, Bray FI, Parkin DM, et al. Cervical cancer as a priority for prevention in different world regions: an evaluation using years of life lost. Int J Cancer 2004; 109 (3): 418–24.PubMedCrossRef
51.
Zurück zum Zitat Goldhaber-Fiebert JD, Stout NK, Ortendahl J, et al. Modeling human papillomavirus and cervical cancer in the United States for analyses of screening and vaccination. Popul Health Metr 2007; 5: 11PubMedCrossRef Goldhaber-Fiebert JD, Stout NK, Ortendahl J, et al. Modeling human papillomavirus and cervical cancer in the United States for analyses of screening and vaccination. Popul Health Metr 2007; 5: 11PubMedCrossRef
52.
Zurück zum Zitat Chesson HW, Ekwueme DU, Saraiya M, et al. Cost-effectiveness of human papillomavirus vaccination in the United States. Emerg Infect Dis 2008 Feb; 14 (2): 244–51PubMedCrossRef Chesson HW, Ekwueme DU, Saraiya M, et al. Cost-effectiveness of human papillomavirus vaccination in the United States. Emerg Infect Dis 2008 Feb; 14 (2): 244–51PubMedCrossRef
53.
Zurück zum Zitat Stratton KR, Durch J, Lawrence RS. Vaccines for the 21st century: a tool for decision making. Institute of Medicine (US): Committee to Study Priorities for Vaccine Development. Washington, DC: National Academy Press, 2000 Stratton KR, Durch J, Lawrence RS. Vaccines for the 21st century: a tool for decision making. Institute of Medicine (US): Committee to Study Priorities for Vaccine Development. Washington, DC: National Academy Press, 2000
54.
Zurück zum Zitat Gold MR, Siegel JE, Russel LB, et al., editors. Cost-effectiveness in health and medicine. New York Oxford University Press, 1996 Gold MR, Siegel JE, Russel LB, et al., editors. Cost-effectiveness in health and medicine. New York Oxford University Press, 1996
55.
Zurück zum Zitat Curtis L, Netten A. Unit costs of health and social care 2005. Kent (UK): University of Kent, PSSRU, 2005 Curtis L, Netten A. Unit costs of health and social care 2005. Kent (UK): University of Kent, PSSRU, 2005
56.
Zurück zum Zitat Ortega-Sanchez IR, Lee GM, Jacobs RJ, et al., Working Group on Leading Economic Issues for New Vaccine for Adolescents. Projected cost-effectiveness of new vaccines for adolescents in the United States. Pediatrics 2008; 121 Suppl. 1: S63–78CrossRef Ortega-Sanchez IR, Lee GM, Jacobs RJ, et al., Working Group on Leading Economic Issues for New Vaccine for Adolescents. Projected cost-effectiveness of new vaccines for adolescents in the United States. Pediatrics 2008; 121 Suppl. 1: S63–78CrossRef
57.
Zurück zum Zitat Newall AT, Beutels P, Wood JG, et al. Cost-effectiveness analyses of human papillomavirus vaccination. Lancet Infect Dis 2007 Apr; 7 (4): 289–96PubMedCrossRef Newall AT, Beutels P, Wood JG, et al. Cost-effectiveness analyses of human papillomavirus vaccination. Lancet Infect Dis 2007 Apr; 7 (4): 289–96PubMedCrossRef
58.
Zurück zum Zitat Myers ER, Green S, Lipkus I. Patient preferences for health states related to HPV infection: visual analog scales versus time trade off elicitation. Proceedings of the 21st International Papillomavirus Conference; 2004 Feb 20–27; Mexico City Myers ER, Green S, Lipkus I. Patient preferences for health states related to HPV infection: visual analog scales versus time trade off elicitation. Proceedings of the 21st International Papillomavirus Conference; 2004 Feb 20–27; Mexico City
Metadaten
Titel
Effectiveness and Cost Effectiveness of Human Papillomavirus Vaccine
A Systematic Review
verfasst von
Dr Fawziah Marra
Karine Cloutier
Bridgette Oteng
Carlo Marra
Gina Ogilvie
Publikationsdatum
01.02.2009
Verlag
Springer International Publishing
Erschienen in
PharmacoEconomics / Ausgabe 2/2009
Print ISSN: 1170-7690
Elektronische ISSN: 1179-2027
DOI
https://doi.org/10.2165/00019053-200927020-00004

Weitere Artikel der Ausgabe 2/2009

PharmacoEconomics 2/2009 Zur Ausgabe

Leading Article

Neuropathic Pain