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Cost-effectiveness analysis of hepatitis A vaccination strategies for adults.
Hepatology. 1999 Oct; 30(4):1077-81.Hep

Abstract

Our objective in this study was to determine the cost-effectiveness 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 cost-effective 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.

Authors+Show Affiliations

Division of Gastroenterology, Department of Medicine, Duke University Medical Center, Durham, NC, USA. oconn003@mc.duke.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10498662

Citation

O'Connor, J B., et al. "Cost-effectiveness Analysis of Hepatitis a Vaccination Strategies for Adults." Hepatology (Baltimore, Md.), vol. 30, no. 4, 1999, pp. 1077-81.
O'Connor JB, Imperiale TF, Singer ME. Cost-effectiveness analysis of hepatitis A vaccination strategies for adults. Hepatology. 1999;30(4):1077-81.
O'Connor, J. B., Imperiale, T. F., & Singer, M. E. (1999). Cost-effectiveness analysis of hepatitis A vaccination strategies for adults. Hepatology (Baltimore, Md.), 30(4), 1077-81.
O'Connor JB, Imperiale TF, Singer ME. Cost-effectiveness Analysis of Hepatitis a Vaccination Strategies for Adults. Hepatology. 1999;30(4):1077-81. PubMed PMID: 10498662.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cost-effectiveness analysis of hepatitis A vaccination strategies for adults. AU - O'Connor,J B, AU - Imperiale,T F, AU - Singer,M E, PY - 1999/9/25/pubmed PY - 1999/9/25/medline PY - 1999/9/25/entrez SP - 1077 EP - 81 JF - Hepatology (Baltimore, Md.) JO - Hepatology VL - 30 IS - 4 N2 - Our objective in this study was to determine the cost-effectiveness 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 cost-effective 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. SN - 0270-9139 UR - https://www.unboundmedicine.com/medline/citation/10498662/Cost_effectiveness_analysis_of_hepatitis_A_vaccination_strategies_for_adults_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0270913999004607 DB - PRIME DP - Unbound Medicine ER -