RT Journal Article
SR Electronic
T1 Governance of preventive Health Intervention and On time Verification of its Efficiency: the GIOVE Study
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e000736
DO 10.1136/bmjopen-2011-000736
VO 2
IS 2
A1 Francesco Saverio Mennini
A1 Gianluca Baio
A1 Giuseppe Montagano
A1 Gabriella Cauzillo
A1 Francesco Locuratolo
A1 Gerardo Becce
A1 Lara Gitto
A1 Andrea Marcellusi
A1 Peter Zweifel
A1 Alessandro Capone
A1 Giampiero Favato
YR 2012
UL http://bmjopen.bmj.com/content/2/2/e000736.abstract
AB 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.