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Governance of preventive Health Intervention and On time Verification of its Efficiency: the GIOVE Study.
, Article e000736. 10.1136/bmjopen-2011-000736.
OBJECTIVES: The GIOVE Study was aimed to the achievement of allocative efficiency of the budget allocated to the prevention of human papillomavirus (HPV)-induced diseases. An ex-ante determination of the most efficient allocation of resources between screening and multicohort quadrivalent immunisation programmes was followed by the ex-post assessment of the allocative efficiency actually achieved after a 12-month period. DESIGN: A bound optimisation model was developed to determine the ex-ante allocative efficiency of resources. The alternatives compared were the screening programme alone and the quadrivalent immunisation with access to screening. A sensitivity analysis was carried out to assess the uncertainty associated with the main inputs of the model. Subsequently, a cohort of girls with a complete recorded vaccination history were enrolled in an observational retrospective study for 18 months to ensure full compliance with the recommended schedule of vaccination (0, 2, 6 months) within a 12-month time horizon. SETTING: Basilicata region, in the south of Italy. PARTICIPANTS: 12 848 girls aged 12, 15, 18 or 25 years. INTERVENTION: Immunisation with quadrivalent anti-HPV vaccine. OUTCOME MEASURES: The vaccination coverage rate was considered to be the indicator of the best achievable benefit, given the budgetary constraints. RESULTS: Assuming a vaccine price of €100 per dose, a vaccination coverage rate of 59.6% was required for the most effective allocation of resources. The optimal rate of coverage was initially in favour of the multicohort strategy of vaccination against HPV (72.8%±2%). When the price paid for the quadrivalent vaccine dropped to €85 per dose, the most efficient coverage rate (69.5%) shifted closer to the immunisation rate actually achieved during the 12-month observation period. CONCLUSIONS: The bound optimisation model demonstrated to be a useful approach to the ex-ante allocation and the ex-post assessment of the resources allocated to the implementation of a multicohort quadrivalent anti-HPV vaccination programme.
|Title:||Governance of preventive Health Intervention and On time Verification of its Efficiency: the GIOVE Study.|
|UCL classification:||UCL > School of BEAMS
UCL > School of BEAMS > Faculty of Maths and Physical Sciences
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