These were estimated by summing up all the CC cases and deaths prevented of the countries constituting each of the WHO continents (i.e. Africa, America, Asia, Europe, Oceania). A worldwide estimate was made by summing up the results for all countries for vaccination coverage

levels ranging from 0 to 100%. The number of CC cases and deaths averted not causally related to HPV-16/18 infection were find more estimated at three possible scenarios of vaccination coverage (50, 70 and 90%) for each WHO continent and worldwide by taking the difference between the CC cases and deaths prevented that

are causally related to HPV-16/18 and the CC cases prevented by vaccination irrespective of HPV type for all countries in the analysis. In five countries (Mexico, Canada, Germany, Thailand OTX015 cost and South African Republic) the expected reduction in CC treatment costs resulting from the cases potentially prevented by HPV vaccination (cost-offset) were estimated. One country among countries with available data was randomly selected from each of the following continents: Asia, Africa, Europe, South America either and North America. The total estimated cost-offset, from the healthcare payer perspective was calculated by multiplying the number of incident CC cases prevented by the country-specific estimated lifetime cost per case: Total cost−offset=incident CC prevented×lifetime costTotal cost−offset=incident CC prevented×lifetime cost For each of the five countries, the total cost-offset

for CC cases prevented irrespective of the causative HPV type, CC prevented causally related to HPV-16/18 infection, and the difference between them, i.e. the additional cost-offset from protection against HPV types other than HPV-16/18 was estimated. For comparison purposes the cost-offset related to CC cases other than HPV-16/18 were converted to international dollars using the 2011 purchase power parity conversion factor for gross domestic product based on data from the World Bank for each country [13]. For each analysis, vaccination coverage was assumed to be 80%. Lifetime CC treatment costs, from a healthcare payer perspective, were obtained from published literature [14], [15], [16], [17], [18] and [19].