OBJECTIVES: To evaluate the cost-effectiveness of a combined primary (vaccination against HPV types 16 and 18) and secondary (population-based cervical cancer screening programme) approach to managing Cervical Intraepithelial Neoplasia (CIN) 1-3 and cervical cancer compared to a cervical cancer screening programme alone in the Irish health care setting. METHODS: The economic analysis was conducted using an independently developed dynamic agent based model [1], which takes account of the herd immunity effect of the vaccine. The study comparator was a population based cervical cancer screening programme. Irish epidemiological and cost data were incorporated into the model. The analysis was performed from the Irish health system perspective with a time horizon of 70 years. The cost-effectiveness of a range of catch-up vaccination strategies were also evaluated. Costs and benefits were discounted at 3.5% per annum. A one way and probabilistic sensitivity analysis were conducted. RESULTS: The base case incremental cost-effectiveness ratio (ICER) was €17,383/LYG. The ICER for the 12-15 year old catch-up programme was €52,968/LYG. The key determinants of cost effectiveness were vaccine efficacy, vaccine costs (including administration costs), duration of protection (i.e. requirement for booster) and the discount rate. Using a probabilistic sensitivity analysis about the base case, the 95% CI for cost per LYG was (€9,658, €24,097). CONCLUSIONS: The results of this HTA suggest that vaccination against HPV types 16 and 18 would be cost-effective from the perspective of the Irish health care payer. Universal vaccination of 12 year old females, against HPV types 16 and 18, can be recommended as a cost-effective intervention in the Irish health care setting. In relation to a catch-up programme, vaccination of 12 to 15 year old females in the first year of the programme would be the most cost-effective catch-up strategy. [1] Danish Centre for Health Technology Assessment (DACEHTA). Reduction in the risk of cervical cancer by vaccination against HPV – a health technology assessment. Health Technology Assessment 2007;9.