Critical Analysis of Two Articles on HPV Vaccination Program using Drummond's Checklist

This essay provides a critical analysis of two articles on the Human Papillomavirus (HPV) vaccination program using Drummond's checklist. It includes a recommendation for UK policy based on the findings of the two articles.

Critique 2 Articles using
Drummonds checklist

Table of Contents
INTRODUCTION...........................................................................................................................3
Was a well-defined question posed in answerable form?......................................................3
Was a comprehensive description of alternatives given?.......................................................4
Was there evidence that effectiveness had been established?................................................4
Were all the important and relevant costs and consequences for each alternative identified?5
Were costs and consequences measured accurately/appropriately?.......................................6
Were costs and consequences valued credibly?.....................................................................6
Were costs and consequences adjusted for differential timing?.............................................6
Was an incremental analysis performed?...............................................................................6
Was allowance made for uncertainty?....................................................................................7
Did presentation/discussion of results include all issues of concern?....................................7
Recommendation for the UK policy which are based on the finding of two articles............7
REFERENCES................................................................................................................................9

INTRODUCTION
This essay includes the critical analysis of two article which are based on the Human
Papillomavirus (HPV) vaccination program. This includes different article which have the
analysis that can relate with using Drummond checklist which can also suggest policy
recommendation for UK. This may include appropriate model which can be applicable for the
deliver information about the economic or other reasons that may include the policy
recommendations. It may also include the cost effectiveness that may include according to NHS.
These two articles include are as follows:
Kim JJ AndresBeck B and Goldie SJ. The value of including boys in an HPV vaccination
programme a costeffectiveness analysis in a lowresource setting British Journal of Cancer 2007
97 1322 1328
Elbasha EH Dasbach EJ Impact of vaccinating boys and men against HPV in the United
States. Vaccine 20102842685867
This essay provides the information which can allow to get recommendation within UK
policy evidence based which are provide within two articles. This paper includes the financial
resources management aspect that are effective and allow to get different effective information
that can help in analysis through these two articles. This essay includes the critical analysis
through using the Drummond checklist which has been designed to guide the critique of
economic evaluations and should consider some question that can allow to effective critique the
article (Näsman and et. al., 2020).
ANALYSIS
This is the section which is effective for analysis the provided two different article
through following the Drummond checklist which are discussed further.
Was a well-defined question posed in answerable form?
There are two different article which are having two different topics/questions where Erik J.
Dasbach includes the impact of vaccinating men and boys against the HPV within US. Whereas,
Goldie provides the information regarding the value of including boys which can include the
HPV vaccination program: a cost effectiveness analysis within low resource setting.
Goldie and Kin also includes the cost effectiveness of pre-adolescent vaccination for
reducing the cervical cancer. This may include the vaccination within pre-adolescent girls

against HPV disease which can associate with the cost effective in cervical screening within U.S.
This also includes the burden on healthcare organization.
Dasbach and Elbasha includes the about vaccination who were asked to reduction in warts in
boys and men which can reduce the rate of cancer within US and are having strong screening
program in women. In this, there is study about HPV types which includes the 6, 11, 16 and 18
that are also known to cause penile, anal along with neck and head cases. HPV transmission to
women can be also a way to virus transmission (Grodzicka, 2021).
Kim and Goldie suggest that there is a cervical cancer which is one of most common cancer
with women worldwide and which have high cases of death occurrence in low-resource
countries. Here, vaccination of Brazilian girls leads to specific attention for strategies which
include screening due to having potential to transmit sexually.
Was a comprehensive description of alternatives given?
Kim and Goldie provides different alternative which are based on two different HPV type 16
along with 18. According to Kim and Goldie, there is identification that within Brazil, there is no
currently any type of screening program which reflect the use of transmission model which can
be used to capture not only the direct protective effective but also help in vaccinated individual.
It also has the potential to indirect effect to reduce the HPV transmission to their partners.
Through this, individual can allow to get mentioned about the vaccination that can be effective in
reduction of cancer risk lifetime through using considered strategies. This also provides the
various benefits along with cost effectiveness ratio through vaccinating coverage for girls and
boys.
According to Dasbach and Elbasha includes about the alternatives which can be based on the
HPV types 6, 11, 16 along with 18. They also describe that there is vaccination program where it
does not provide the information about het vaccine options. There is quality of life weights and
cost which in includes the cancer, pre-cancer along with genital warts (Lehtinen and et. al.,
2018). There is also susceptibility of residual which can include the infection within all types of
HPV. This includes the age group of 6-26 years where they uptake the first dose and
subsequently doses.
Was there evidence that effectiveness had been established?
According to Goldie and Kim, there are many of the studies which implies the
effectiveness of the different information that may include the effectiveness. There was the

assumption to about the vaccine which was given to girls and boys less than 12 years should get
lifetime protection through vaccine against the HPV 16 and 18. There is some accessing to the
pre cancer along with cervical cancers who should not possess any type of potential illness.
There is very less data due to natural histories over years. There is also risk factor which may
include smoking obesity and many more. There are also children with equal access to the vaccine
where some children lives in rural area or don't have potential to attend a school which can create
impact on their coverage. It also includes the information what will happen when all three doses
are not taken and there is also assumption about first dose in girls and women are about 75% and
vaccine was about 100%. Whereas, in boys and men efficacy was about 85%. There was also an
estimated cost for the vaccine was about $500 (Bishop and et. al., 2022) .
According to Dasbach and Elbasha study, there are some of the information which has
been established effectiveness that may include that a study was based on the 9-26 years old age
group which have the assumption that why any individual does not take 3 doses of vaccination
then there is no any efficacy of vaccine. It also cover the girl and women with 50% by age of 12
whereas at age of 18 it is 85% and by age of 26 it is about more than 90%. Cost of vaccination
was estimated about $100 to $400 cheaper than the vaccination cost of study within Goldie and
Kim study.
Were all the important and relevant costs and consequences for each alternative identified?
In this section, there is discussion about wide range of study about the costs and its
consequences for each alternative (Guo and et. al., 2020) .
According to Kim and Goldie view point for the department of health that it need to
reduce the cancer within low resource countries. Whereas in group of 12 are considered where it
includes the HPV types 16 and 18. It also includes cost for the lifetime and includes the indirect
medical cost and non-medical cost along with incremental cost effectiveness ratio. It also
includes the operation cost which are included and provide the consequences quality adjust life
year (QALY) that has been considered.
According to Dasbach and Elbasha study, it has been informed that it can be accessed
from public health perspective which have the range within 9 to 26 years or both male and
female. It also includes the vaccine cost without any operating cost is specified like a waste and
administration cost, transportation cost and many more. As a consequence quality adjusted life

has considered. It also provide no operating cost and equality adjusted life year (QALY) is also
considered within this study (Zhu and et. al., 2019) .
Were costs and consequences measured accurately/appropriately?
This section includes that measurement of cost and consequent which is accurate or not.
According to Golden & Kim study provide information that there was no consideration of
the quadrivalent vaccine which can help to prevent n type 6 and 11 for reducing the cervical
cancer (de Sanjose and et. al., 2020). It can impact on improve cost effectiveness and due to not
having more data, it did not effectively include the other cancer. There was no any type of
special circumstances identified. Hindi Sabir was no inclusion of bisexual and homosexual
partnership model.
According to the Dasbach and Elbasha, information provided that there is no any
valuation of male vaccination extent of female coverage. It includes the model on homosexual
and bisexual partnership which was not involved and no any special circumstances has been
identified. In this, there is also no inclusion of bisexual and homosexual partnerships (Bayefsky,
2018).
Were costs and consequences valued credibly?
This section includes client preferences, policymakers views, along with health
professional and market value (Agrawal and et. al., 2018) .
According to Golden and Kim, there was estimated cost for a dose at $500 including all
the extra expenses having 100% efficacy.
According to Dasbach and Elbasha vaccination cost was $400 which includes all the cost
for the series. Efficacy is lower having range 76 to 96% within girls and women.
Were costs and consequences adjusted for differential timing?
This section includes some discount on cost and consequences during present time.
According to Golden and Kim, there was a future cost with annually for economic evaluation
that was based on published guidelines (Murillo and et. al., 2019).
According to Dasbach and Elbasha, there was some discount provided according to
present value which can be considered as a period of 100 years when benefits can be observed.
Was an incremental analysis performed?
This section includes the incremental analysis of alternatives.

According to Golden and Kim, it provide the clinical benefit with covering vaccination
for an individual about 25 to 95% within girls through using variable cost for the vaccinated
individual (Anderson and et. al., 2018).
According to the Dasbach and Elbasha for preventing cervical disease. It was about
46,084 QUALY which was also include the HPV disease (Daniel and et. al., 2019).
Was allowance made for uncertainty?
In this section, there is inclusion of value through the sensitivity analysis to improve the cost of
confidence and also includes a statistical analysis.
According to Golden and Kim, there is a sensitivity analysis which includes non cost in
HPV types natural immunity along with other HPV types.
According to the Dasbach and Elbasha study can indicate that sensitivity analysis
includes cost and quality uptake and properties which are not including screening natural history
behaviour early screening parameters (Walling and et. al., 2019).
Did presentation/discussion of results include all issues of concern?
According to Golden and Kim, it can be targeted that through vaccination for the cervical
cancer allowed to help in reduce the death within country. It also provide the information that a
pre-adolescent vaccination programme has high cost effective in nature through adding boys and
men.
According to Dasbach and Elbasha price of vaccine was needed to lower the threshold for
providing cost effective program. It also includes the community perception terms of equity
political reality and cultural preferences which have their own rule (Lepkowska, 2019).
Recommendation for the UK policy which are based on the finding of two articles
According to point B of cost effectiveness. There is a need to recommend that a
vaccination program for type 16 and 11 within women and girl with age of 9 to 26 can have
maximum coverage. This can help in reducing cervical cancer that and provide good screening.
Through including men and boys cannot create cost effective and can also help to improve health
outcomes.
Instead of only disease and cancer, there is also need to ensure about the financial benefit
which can provide better help as a infertility in later years. Through significant cost of Health

Service can help to provide better scope in future or data mining has consequences which cannot
be just cost-effectiveness.
From above discussion, it can be recommended that there is a critical recommendation
which can about the vaccination program for type 11 and 16 within girls and women. There is a
cost-effectiveness which have the maximum coverage of 90% for reducing death. Due to cervical
cancer, it can also include the use of good screening program for including men and boys. There
may be not any cost effective which can improve health outcome and can improve cancers which
are associated with HPV 6 and 11 within and panile, anal and RRB.
It is also recommended about the decision which should not just cost-effectiveness but have also
equity point of view for men and boys. This can include covering all type of 6, 11, 16 and 18 in
the program and not have cost-effective initially. However, financial analysis can include the
first instant which can economic early have a better effect in later year and have a highly
beneficial for the longer term.
In this, there is not only to need to see the disease and cancer but it is also needed to
ensure about the financial benefit which can be used in later year and can provide different
studies in this health service. There is need for cost for IVF which are significant and can provide
mental health issue through the study which need to determine other health related consequences
and should not be any cost effectiveness.
Through using the preventable medication can provide a reactive medication within life
for the year. It is also recommended that UK is a developed country and should be used better
bargaining power to creating cost of the vaccine in which can provide better cost effectiveness
through the program. It is also recommended to include all men and boys along with girls and
women from age 9 to 16l. In this program that can have ability to cover all type of 6, 11, 16 and
18 can be cost effectiveness for better instance.

REFERENCES
Books and Journals
Agrawal and et. al., 2018. Who calls the shots? The ethics of adolescentself-consent for HPV
vaccination. Journal of medical ethics, 44(8), pp.531-535.
Anderson and et. al., 2018. Primary care physicians’ role in parental decision to vaccinate with
HPV vaccine: learnings from a South Texas Hispanic patient population. Journal of
immigrant and minority health, 20(5), pp.1236-1242.
Bayefsky, 2018. The ethical case for mandating HPV vaccination. Journal of Law, Medicine &
Ethics, 46(2), pp.501-510.
Bishop and et. al., 2022. Evaluation of HPV Vaccine: Same Way, Same DayTM: A Pilot
Study. Journal of health communication, pp.1-7.
Daniel and et. al., 2019. HPV and HPV vaccination knowledge and attitudes among medical
students in Alabama. Journal of Cancer Education, pp.1-10.
de Sanjose and et. al., 2020. Is It Now the Time to Plan for Global Gender-Neutral HPV
Vaccination?. The Journal of infectious diseases, 222(6), pp.888-889.
Grodzicka, 2021. Taking vaccine regret and hesitancy seriously. The role of truth, conspiracy
theories, gender relations and trust in the HPV immunisation programmes in
Ireland. Journal for Cultural Research, 25(1), pp.69-87.
Guo and et. al., 2020. Human papillomavirus (HPV) vaccination initiation and completion
among adult males in the United States. The Journal of the American Board of Family
Medicine, 33(4), pp.592-599.
Lehtinen and et. al., 2018. Impact of gender‐neutral or girls‐only vaccination against human
papillomavirus—Results of a community‐randomized clinical trial (I). International
journal of cancer, 142(5), pp.949-958.
Lepkowska, 2019. No catch-up programme planned for HPV immunisation in boys. British
Journal of School Nursing, 14(1), pp.11-12.
Murillo and et. al., 2019. Human papillomavirus (HPV) vaccination: From clinical studies to
immunization programs. International Journal of Gynecologic Cancer, 29(8).
Näsman and et. al., 2020. A global epidemic increase of an HPV‐induced tonsil and tongue base
cancer–potential benefit from a pan‐gender use of HPV vaccine. Journal of internal
medicine, 287(2), pp.134-152.
Walling and et. al., 2019. Implementation of strategies to improve human papillomavirus vaccine
coverage: a provider survey. American journal of preventive medicine, 56(1), pp.74-83.
Zhu and et. al., 2019. Factors Related to Chinese Parents' HPV Vaccination Intention for
Children. American journal of health behavior, 43(5), pp.994-1005.