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  1. Cost-effectiveness analysis of hepatitis A vaccination strategies for adults.

    Article - En anglais

    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.

    Mots-clés Pascal : Hépatite virale A, Virose, Infection, Immunoprophylaxie, Stratégie, Analyse coût efficacité, Incidence, Homme, Adulte, Etats Unis, Amérique du Nord, Amérique, Appareil digestif pathologie, Foie pathologie, Economie santé

    Mots-clés Pascal anglais : Viral hepatitis A, Viral disease, Infection, Immunoprophylaxis, Strategy, Cost efficiency analysis, Incidence, Human, Adult, United States, North America, America, Digestive diseases, Hepatic disease, Health economy

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 99-0495256

    Code Inist : 002B05C02G. Création : 22/03/2000.