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Regional variation in the cost effectiveness of childhood hepatitis A immunization.
Pediatr Infect Dis J. 2003 Oct; 22(10):904-14.PI

Abstract

BACKGROUND

Routine childhood hepatitis A immunization is recommended in regions with incidence rates twice the national average, but it may be cost-effective in a wider geographic area.

OBJECTIVE

To evaluate the costs and benefits of potential hepatitis A immunization of healthy US children in regions with varying hepatitis A incidences.

METHODS

We considered vaccination of the 2000 US birth cohort in states defined by historic hepatitis A incidence rates. Infections among potential vaccinees and their personal contacts were predicted from age 2 through 85 years. Net vaccination costs were estimated from health system and societal perspectives and were compared with life-years saved and quality-adjusted life years (QALYs) gained using a 3% discount rate. RESULTS Nationally vaccination would prevent >75 000 cases of overt hepatitis A disease. Approximately two-thirds of health benefits would accrue to personal contacts rather than to vaccinees themselves. In states with incidence rates of > or =200%, 100 to 199%, 50 to 99% and <50% the national average, societal costs per QALY gained would be <0, <0, 13,800 and 63,000 US dollars, respectively. Nationally vaccination would cost 9100 US dollars per QALY gained from the perspective of the health system and 1400 US dollars per QALY gained from society's perspective. Results are most sensitive to vaccination costs and rates of disease transmission through personal contact.

CONCLUSION

Childhood hepatitis A vaccination is most cost-effective in areas with the highest incidence rates but would also meet accepted standards of economic efficiency in most of the US. A national immunization policy would prevent substantial morbidity and mortality, with cost effectiveness similar to that of other childhood immunizations.

Authors+Show Affiliations

Capitol Outcomes Research, Inc, Alexandria, VA 22310, USA. Jake.Jacobs@CapitolOutcomesResearch.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

14551492

Citation

Jacobs, R Jake, et al. "Regional Variation in the Cost Effectiveness of Childhood Hepatitis a Immunization." The Pediatric Infectious Disease Journal, vol. 22, no. 10, 2003, pp. 904-14.
Jacobs RJ, Greenberg DP, Koff RS, et al. Regional variation in the cost effectiveness of childhood hepatitis A immunization. Pediatr Infect Dis J. 2003;22(10):904-14.
Jacobs, R. J., Greenberg, D. P., Koff, R. S., Saab, S., & Meyerhoff, A. S. (2003). Regional variation in the cost effectiveness of childhood hepatitis A immunization. The Pediatric Infectious Disease Journal, 22(10), 904-14.
Jacobs RJ, et al. Regional Variation in the Cost Effectiveness of Childhood Hepatitis a Immunization. Pediatr Infect Dis J. 2003;22(10):904-14. PubMed PMID: 14551492.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Regional variation in the cost effectiveness of childhood hepatitis A immunization. AU - Jacobs,R Jake, AU - Greenberg,David P, AU - Koff,Raymond S, AU - Saab,Sammy, AU - Meyerhoff,Allen S, PY - 2003/10/11/pubmed PY - 2003/12/10/medline PY - 2003/10/11/entrez SP - 904 EP - 14 JF - The Pediatric infectious disease journal JO - Pediatr Infect Dis J VL - 22 IS - 10 N2 - BACKGROUND: Routine childhood hepatitis A immunization is recommended in regions with incidence rates twice the national average, but it may be cost-effective in a wider geographic area. OBJECTIVE: To evaluate the costs and benefits of potential hepatitis A immunization of healthy US children in regions with varying hepatitis A incidences. METHODS: We considered vaccination of the 2000 US birth cohort in states defined by historic hepatitis A incidence rates. Infections among potential vaccinees and their personal contacts were predicted from age 2 through 85 years. Net vaccination costs were estimated from health system and societal perspectives and were compared with life-years saved and quality-adjusted life years (QALYs) gained using a 3% discount rate. RESULTS Nationally vaccination would prevent >75 000 cases of overt hepatitis A disease. Approximately two-thirds of health benefits would accrue to personal contacts rather than to vaccinees themselves. In states with incidence rates of > or =200%, 100 to 199%, 50 to 99% and <50% the national average, societal costs per QALY gained would be <0, <0, 13,800 and 63,000 US dollars, respectively. Nationally vaccination would cost 9100 US dollars per QALY gained from the perspective of the health system and 1400 US dollars per QALY gained from society's perspective. Results are most sensitive to vaccination costs and rates of disease transmission through personal contact. CONCLUSION: Childhood hepatitis A vaccination is most cost-effective in areas with the highest incidence rates but would also meet accepted standards of economic efficiency in most of the US. A national immunization policy would prevent substantial morbidity and mortality, with cost effectiveness similar to that of other childhood immunizations. SN - 0891-3668 UR - https://www.unboundmedicine.com/medline/citation/14551492/Regional_variation_in_the_cost_effectiveness_of_childhood_hepatitis_A_immunization_ L2 - https://doi.org/10.1097/01.inf.0000091295.53969.6a DB - PRIME DP - Unbound Medicine ER -