Cost-effectiveness analysis of hepatitis A vaccination strategies for adults.
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
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0495256
Code Inist : 002B05C02G. Création : 22/03/2000.