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The cost-effectiveness of hepatitis A vaccination in patients with chronic hepatitis C viral infection in the United States.
Am J Gastroenterol. 2002 Mar; 97(3):721-8.AJ

Abstract

OBJECTIVE

Hepatitis A vaccination is recommended for patients with chronic hepatitis C. Our aim was to analyze the cost-effectiveness of hepatitis A vaccination in these patients. The specific strategies evaluated were: no vaccination, targeted vaccination, and universal vaccination.

METHODS

Clinical estimates were based on published data. Costs estimates were based on published data and institutional Medicare reimbursement rates. Health-related quality-of-life weights were derived from published data and expert estimates. The target population consisted of patients 45 yr of age with chronic hepatitis C followed every 6 months until death. We adopted a societal perspective.

RESULTS

Compared with no vaccination, targeted vaccination was associated with an incremental cost-effectiveness ratio of $51,000 per quality-adjusted life-year. The incremental cost-effectiveness ratio of universal vaccination compared with targeted vaccination was $3,900,000 per quality-adjusted life-year. The results were particularly sensitive to the incidence of hepatitis A, probability of fulminant hepatic failure, and costs of hepatitis A antibody screening and vaccination.

CONCLUSIONS

Targeted vaccination for hepatitis A in patients with chronic hepatitis C may be a cost-effective strategy to decrease the morbidity and mortality associated with hepatitis A superinfection. Universal vaccination is not a cost-effective alternative to targeted vaccination in this target population.

Authors+Show Affiliations

Division of Gastroenterology and Hepatology, School of Public Health, University of Alabama at Birmingham, 35294-0007, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

11922569

Citation

Arguedas, Miguel R., et al. "The Cost-effectiveness of Hepatitis a Vaccination in Patients With Chronic Hepatitis C Viral Infection in the United States." The American Journal of Gastroenterology, vol. 97, no. 3, 2002, pp. 721-8.
Arguedas MR, Heudebert GR, Fallon MB, et al. The cost-effectiveness of hepatitis A vaccination in patients with chronic hepatitis C viral infection in the United States. Am J Gastroenterol. 2002;97(3):721-8.
Arguedas, M. R., Heudebert, G. R., Fallon, M. B., & Stinnett, A. A. (2002). The cost-effectiveness of hepatitis A vaccination in patients with chronic hepatitis C viral infection in the United States. The American Journal of Gastroenterology, 97(3), 721-8.
Arguedas MR, et al. The Cost-effectiveness of Hepatitis a Vaccination in Patients With Chronic Hepatitis C Viral Infection in the United States. Am J Gastroenterol. 2002;97(3):721-8. PubMed PMID: 11922569.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The cost-effectiveness of hepatitis A vaccination in patients with chronic hepatitis C viral infection in the United States. AU - Arguedas,Miguel R, AU - Heudebert,Gustavo R, AU - Fallon,Michael B, AU - Stinnett,Aaron A, PY - 2002/4/2/pubmed PY - 2002/4/20/medline PY - 2002/4/2/entrez SP - 721 EP - 8 JF - The American journal of gastroenterology JO - Am J Gastroenterol VL - 97 IS - 3 N2 - OBJECTIVE: Hepatitis A vaccination is recommended for patients with chronic hepatitis C. Our aim was to analyze the cost-effectiveness of hepatitis A vaccination in these patients. The specific strategies evaluated were: no vaccination, targeted vaccination, and universal vaccination. METHODS: Clinical estimates were based on published data. Costs estimates were based on published data and institutional Medicare reimbursement rates. Health-related quality-of-life weights were derived from published data and expert estimates. The target population consisted of patients 45 yr of age with chronic hepatitis C followed every 6 months until death. We adopted a societal perspective. RESULTS: Compared with no vaccination, targeted vaccination was associated with an incremental cost-effectiveness ratio of $51,000 per quality-adjusted life-year. The incremental cost-effectiveness ratio of universal vaccination compared with targeted vaccination was $3,900,000 per quality-adjusted life-year. The results were particularly sensitive to the incidence of hepatitis A, probability of fulminant hepatic failure, and costs of hepatitis A antibody screening and vaccination. CONCLUSIONS: Targeted vaccination for hepatitis A in patients with chronic hepatitis C may be a cost-effective strategy to decrease the morbidity and mortality associated with hepatitis A superinfection. Universal vaccination is not a cost-effective alternative to targeted vaccination in this target population. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/11922569/The_cost_effectiveness_of_hepatitis_A_vaccination_in_patients_with_chronic_hepatitis_C_viral_infection_in_the_United_States_ L2 - https://doi.org/10.1111/j.1572-0241.2002.05554.x DB - PRIME DP - Unbound Medicine ER -