Results: 3

1.
Figure 1

Figure 1. From: Governance of preventive Health Intervention and On time Verification of its Efficiency: the GIOVE Study.

Sensitivity analysis of allocative efficiency performed on the basis of variations in the main parameters implied in the bound optimisation model. Figure shows the optimal rate of coverage is highly elastic to large reductions in price of the anti-human papillomavirus (HPV) vaccine of choice, almost linearly elastic to changes in total budget and population eligible for anti-HPV prevention programmes and virtually inelastic to the cost of screening.

Francesco Saverio Mennini, et al. BMJ Open. 2012;2(2):e000736.
2.
Figure 3

Figure 3. From: Governance of preventive Health Intervention and On time Verification of its Efficiency: the GIOVE Study.

Relationship between coverage rate and number of cohorts vaccinated.21 Figure illustrates the expected long-term effect of the vaccination, correlated to the number of cohorts targeted. The combined reduction of all events, such as abnormal Pap smears, colposcopies, Atypical Squamous Cells of Undetermined Significance, Low-grade Squamous Intraepithelial Lesion, High-grade Squamous Intraepithelial Lesions, cervical cancer and genital warts, showed a significant difference between the second and the third cohort. The vaccination of three to four cohorts was likely to enhance the percentage of events avoided, shortening the time required to reach the optimal cost/effective outcome.

Francesco Saverio Mennini, et al. BMJ Open. 2012;2(2):e000736.
3.
Figure 2

Figure 2. From: Governance of preventive Health Intervention and On time Verification of its Efficiency: the GIOVE Study.

Sensitivity analysis of allocative efficiency performed on the basis of variations in budget and cost of vaccine. Figure shows the general case where, by using an optimisation procedure, the authorities in Basilicata could maintain the current high rate of coverage with a reduced budget (equivalent to a reduction in the cost of the vaccine from €85, point α, to €72.5 per dose, point β). Alternatively, the rate of coverage could be reduced to the optimal value of 69%, thereby achieving the concomitant savings (point γ). Further reductions in price, as reflected in the progression towards point δ, should provide scope for savings that can be represented by the shaded area (αγδ). In this way, regional decision makers could authorise the reallocation of resources to other programmes of prevention, while maintaining the expected high level of efficiency of the planned programme of vaccination against human papillomavirus. Regional authorities might also decide to reduce the allocated budget by 10%. In such scenario, although the intercept is still within the boundary of the allocative efficiency curve, an immediate mean decrease of vaccination coverage rate of 10.1%±0.9% would be observed. This would have the knock-on effect of reducing some of the clinical benefits.

Francesco Saverio Mennini, et al. BMJ Open. 2012;2(2):e000736.

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