OBJECTIVES: To determine costs caused by human papillomavirus (HPV) and to evaluate the cost-effectiveness of vaccinating 12 year old females with a quadrivalent HPV vaccine in Finland.METHODS: A comprehensive analysis, based on Finnish national healthcare, social insurance and cancer registries, allowed to evaluate the costs associated with cervical cancers, cervical lesions and genital warts diagnosed between 2001 and 2005 (health care costs, sick-leave compensations, disability pensions, and loss of productivity). An incidence-based model working in discrete time steps was developed to evaluate the effects of HPV vaccine. The model utilised Monte Carlo simulation to produce the outputs. Age-specific cervical cancer incidence rates were derived from population-based cancer registries. The model followed four cohorts of 12 year old females through their lives and the vaccine was assumed to be 100% effective against HPV types 6, 11, 16, 18. The analysis was performed from health care payer and societal perspectives. Sensitivity analyses were carried out to explore the effects of discount rates. RESULTS: Screening and management of HPV related diseases cost annually €50M in Finland. Treatment of genital warts, cervical dysplasia and cancer costs €37M. Solely pap screening costs €13M. Vaccination of 12 year old females against HPV types 6, 11, 16 and 18 would cost €6,957 per additional QALY gained (no discounting) and €11,122/QALY (3.5% discounting for money and 1.5% for health benefits). CONCLUSIONS: Currently HPV causes significant health care costs for Finland. As €50,000/QALY is generally considered to be the threshold of cost-effective treatment in the developed countries, vaccination of 12 years old girls against 6, 11, 16, 18 HPV types would be an effective and economically profitable method to reduce the burden of the HPV related diseases.