To assess the cost effectiveness of adding universal hepatitis B vaccination in infancy or pre-adolescence to a policy of selective vaccination of at risk groups.
Costs of a selective policy and additional costs of universal vaccination policies were estimated from costs of vaccine delivery and published data on target populations.
Additional years oflife gained were calculated for each policy by applying life tables to estimates of mortality attributable to hepatitis B. Setting - England and Wales.
Compared with no vaccination, vaccination in infancy was the most cost effective followed by vaccination in pre-adolescence.
Selective vaccination was the least effective.
Adding vaccination in infancy or at pre-adolescence to a selective policy cost £1537 or £1658 per year of life gained.
Discounting years gained in the future at 6% per annum, however, made pre-adolescent vaccination more cost effective than infant or selective vaccination.
Universal vaccination against hepatitis B was more cost effective than selective vaccination in a low prevalence country.
Discounting future health gain, however, made universal infant vaccination lest cost effective than universal pre-adolescent vaccination.
If future health gained is as important as present gain the addition of universal vaccination to a selective policy is equivalent to the cost per quality adjusted year of life from renal transplantation or breast cancer screening.
Mots-clés Pascal : Hépatite virale B, Virose, Infection, Vaccination, Prévention, Analyse coût efficacité, Programme sanitaire, Age, Enfant, Homme, Etude comparative, Economie santé, Royaume Uni, Europe, Appareil digestif pathologie, Foie pathologie
Mots-clés Pascal anglais : Viral hepatitis B, Viral disease, Infection, Vaccination, Prevention, Cost efficiency analysis, Sanitary program, Age, Child, Human, Comparative study, Health economy, United Kingdom, Europe, Digestive diseases, Hepatic disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0424561
Code Inist : 002B05C02G. Création : 01/03/1996.