Cost-effectiveness analysis of hepatitis A vaccination strategies for adults

✍ Scribed by J. Barry O'Connor; Thomas F. Imperiale; Mendel E. Singer

• Publisher: John Wiley and Sons
• Year: 1999
• Tongue: English
• Weight: 97 KB
• Volume: 30
• Category: Article
• ISSN: 0270-9139
• DOI: 10.1002/hep.510300422

✦ Synopsis

Our objective in this study was to determine the costeffectiveness of hepatitis A vaccination strategies in healthy adults in the United States. We constructed a decision model simulating costs and health consequences for otherwise healthy adults with respect to hepatitis A prevention. Three strategies were compared: (1) no intervention, (2) vaccination against hepatitis A, and (3) testing for antibodies to hepatitis A and vaccinating those without antibodies. Costs and probabilities were obtained from the published literature. One-and two-way sensitivity analyses were performed. Under baseline conditions, the ''test'' strategy cost $230,100 per life-year saved compared with the ''no intervention'' strategy. The incremental cost-effectiveness of the ''vaccination'' strategy compared with the ''test'' strategy was $20.1 million per life-year saved. The ''test'' strategy was cost-effective when the hepatitis A case fatality rate exceeded 17% (baseline 2.7%). The ''vaccination'' strategy was cost-effective when 1 dose of vaccine cost $7 or less (baseline $57). Under baseline conditions, neither the ''test'' nor the ''vaccination'' strategies are considered costeffective according to current standards. Large changes in hepatitis A incidence, mortality rates, or vaccine cost are required for either of the intervention strategies to approach potentially cost-effectiveness. Such conditions may occur in areas in which hepatitis A is endemic, and/or under mass-vaccination scenarios.