Under limited budget of health care, it is important to deliver health care services efficiently. Health technology assessment, including economic evaluation, is one of the tools to evaluate efficiency of new technology. Since some of the vaccines are covered by public fund, it is also important to consider its cost effectiveness. Though basic methods of economic evaluation have been established, there are some methodological variations.
While cervical cancer is one of the major causes of cancer death in Japan, HPV vaccine is one option for preventing cervical cancer. However, HPV vaccination program may cost a lot compared with other vaccination programs. Economic evaluation of HPV vaccination is important. There is an economic evaluation study comparing vaccination program for all 12-year-old girls with regular screening test to just screening program. The study used quality adjusted life years (QALY) as the outcome measure and adopted health care payer perspective. The study was based on lifetime Markov model, which was consisted of 12 different health states. All effects and costs were discounted 3% annually. According to the model, the incidence and mortality of cervical cancer would be reduced 73% during the life time. Total cost of vaccines would be 21 billion yen, while health care cost would be reduced 6.5 billion yen. Incremental cost effectiveness ratio was 1.8 million yen per QALY gained.
In order to compare the result of economic evaluation study, it is important to standardize the methods for evaluation. In 2011, the research group organized by the government set the standardized methods and evaluated several vaccination programs. This approach suggested a new step toward decisions of efficient resource use.
In the session, general methods of economic evaluation will be presented with an example of HPV vaccination program. Then the use of economic evaluation for decision making will be discussed.