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Published 19 November 2008, doi:10.1136/bmj.a2552
Cite this as: BMJ 2008;337:a2552
| The first 150 words of the full text of this article appear below. |
It was unfortunate that Hammond wrote his piece without asking us the governments reasons for choosing the human papillomavirus (HPV) vaccine.1 We fully considered all of the issues he raised and much more that was scientific, logistic, and economic.
We used the cost effectiveness analysis of Jit et al to allocate points for the quality of scientific information on protection against cervical cancer, protection against warts, and stability out of the cold chain,2 and only after the scoring was completed were the prices revealed. With the same analysis,2 the prices were scored for cost effectiveness in balance with the other factors. The scoring system had been shared in advance with the manufacturers. In central contracts the price offered by manufacturers can differ considerably between products and against the list price.
We took full account of the burden of genital warts and the benefits that might come from vaccinating males. Perhaps
David M Salisbury, director of immunisation1
1 Department of Health, London SW1A 2NS
judith.moore@dh.gsi.gov.uk
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