Hostname: page-component-848d4c4894-r5zm4 Total loading time: 0 Render date: 2024-06-21T02:40:46.821Z Has data issue: false hasContentIssue false
  • English
  • Français

Cost-Benefit Analysis of Hepatitis-B Vaccination: A Computerized Decision Model for Spain

Published online by Cambridge University Press:  10 March 2009

Bengt Jönsson ,
Bruno Horisberger ,
Miguel Bruguera  and
Lukas Matter
Bengt Jönsson
Affiliation:
Linköping University
Bruno Horisberger
Affiliation:
Interdisciplinary Research Center for Public Health
Miguel Bruguera
Affiliation:
University of Barcelona
Lukas Matter
Affiliation:
University of Bern
Get access Rights & Permissions [Opens in a new window]

Abstract

The availability and efficacy of recombinant deoxyribonucleic acid yeast-derived hepatitis-B vaccine, at a price much lower than the previously available plasma-derived hepatitis-B vaccines against hepatitis-B virus infections, motivate a new cost-benefit analysis of hepatitis-B vaccination. Spanish data were used to calculate direct and indirect costs of hepatitis-B infection and the costs and benefits of different vaccination strategies in defined risk groups of the Spanish population. A vaccination program will reduce direct expenditures for hepatitis B if the attack rate in the target population is higher than 4.9%. If indirect costs are included, the threshold for cost saving is reduced to 0.9%. The results are sensitive to the price of the vaccine, the duration of protection, assumptions about consequences for quality of life, and to indirect costs.

Type
General Essays
Information
International Journal of Technology Assessment in Health Care , Volume 7 , Issue 3 , Summer 1991 , pp. 379 - 402
Copyright
Copyright © Cambridge University Press 1991

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.ACIP. Recommendations for protection against viral hepatitis. Morbidity and Mortality Weekly Report, 1985, 34, 313–35.Google Scholar
2.Adler, M. W., et al. Should homosexuals be vaccinated against hepatitis-B virus? Cost and benefit assessment. British Medical Journal, 1983, 80, 139–48.Google Scholar
3.Aparicio, J. A., Dean, C. A., Tellez, A. R., et al. Aspectos de la transmision intrafamiliar del virus de la hepatitis B en una familia de raza gitana. Medicina Clinica (Barcelona), 1987, 88, 828.Google Scholar
4.Bengoechea, M. G., Cortes, A., Francisco, C., et al. Infection por el virus de la hepatitis B en los odentólogos de Guipuzcoa. Medicina Clinica (Barcelona), 1987, 88, 179–81.Google Scholar
5.Berger, M. C., Blomquist, G. C., Kenkel, D., & Tolley, G. S.Valuing changes in health risks: A comparison of alternative measures. Southern Economic Journal, 1987, 53, 967–84.CrossRefGoogle Scholar
6.Bortollotti, A., et al. Chronic evolution of acute hepatitis type B: Prevalence and predicative markers. Infection, 1986, 14, 64–67.CrossRefGoogle Scholar
7.Bove, J. R.Transfusion-associated hepatitis and AIDS: What is the risk? New England Journal of Medicine, 1987, 317, 242–45.CrossRefGoogle ScholarPubMed
8.Bruguera, M.La hepatitis B en el personal sanitario. Medicina Clinica (Barcelona), 1986, 86, 676–80.Google Scholar
9.Bruguera, M., Ardiaca, C., Semente, M., et al. Epidemiologia de la hepatitis B en personal hospitalario. Revista de Medicina Clinica, 1980, 74, 1–4.Google Scholar
10.Bruguera, M., Caballeria, J., Acero, D., et al. Transmisión intrafamiliar del virus de la hepatitis B. Gastroenerologia y Hepatologia, 1980, 3, 13–18.Google Scholar
11.Bruguera, M., Tapias, J. M. S., Latorre, X., et al. Marcadores serológicos de la hepatitis A y B en los homosexuales masculinos. Medicina Clinica (Barcelona), 1987, 88, 869.Google Scholar
12.Buti, M., Esteban, R., Sanjose, R., et al. Prevalencia de marcadores de infección de los virus de la hepatitis B: Delta y HLTV-III en deficientes mentales. Revista Clinica Espanola, 1986, 179, 175–77.Google Scholar
13.Caballero, L. R., Lopez, F. V., Manuel, C. A., et al. Prevalencia de los marcadores sȳricos del virus B de la hepatitis en varones heterosexuales con enfermedas de transmisión sexual. Medicina Clinica (Barcelona), 1986, 87, 309–12.Google Scholar
14.CDC. Recommendations for prevention of HIV transmission in health-care settings. Morbidity and Mortality Weekly Report, 1987, 36, 2S.Google Scholar
15.Coursaget, P., Yvonnet, B., Chotard, J., et al. Age- and sex-related study of hepatitis B virus chronic carrier state in infants from an endemic area (Senegal). Journal of Medical Virology, 1987, 22, 1–5.CrossRefGoogle ScholarPubMed
16.Economic aspects of communicable diseases. European Reports and Studies, No. 68. Copenhagen: WHO Regional Office for Europe, 1982.Google Scholar
17.Fos, E., Dieguez, A., Hierro, F. R., et al. Infección por el virus de la hepatitis B en la población de raza gitana. Medicina Clinica (Barcelona), 1986, 86, 304.Google Scholar
18.Genesca, J., Esteban, J. I., Esteban, R., et al. Difusión intrafamiliar del virus de la hepatitis B. Estudio de contactos familiares de portadores cronicos. Medicina Clinica (Barcelona), 1986, 87, 271–74.Google Scholar
19.Hadler, S. C., Francis, D. P., Maynard, J. E., et al. Long-term immunogenicity and efficacy of hepatitis B vaccine in homosexual men. New England Journal of Medicine, 1986, 315, 209–14.CrossRefGoogle ScholarPubMed
20.Hatziandreu, E. I., et al. A cost-effectiveness analysis of vaccination against hepatitis-B infection (paper presented at the Third Annual ISTAHC Meeting).Google Scholar
21. Horisberger, B., & Jönsson, B. Economic burden of hepatitis-B in Spain (mimeo).Google Scholar
22.Instituto Nacional de Sanidad, Centro Nacional de Microbiologia, Virologia e Inmunologia Sanitarias, Majadahonda, Madrid, 05 27, 1986.Google Scholar
23.Jauregui, S. J. M., Garay, S. C. F., Odriozola, M. P., et al. Prevalencia de infección por virus de la hepatitis (VHB) en drogadictos asintomaticos. Medicina Clinica (Barcelona), 1984, 82, 13–15.Google Scholar
24.Jönsson, B.Cost-benefit analysis of hepatitis-B vaccination. Postgraduate Medical Journal, 1987, 63(suppl. 2), 27–32.Google ScholarPubMed
25.Kind, P., Rosser, R., & Williams, A.Valuation of quality of life: Some psychometric evidence. In Jones-lee, M. W. (ed.), The value of life and safety. Amsterdam: Elsevier/North Holland, 1982.Google Scholar
26.Kumar, M. L., Dawson, N. V., McCullough, A. J., et al. Should all pregnant women be screened for hepatitis B? Annals of Internal Medicine, 1987, 107, 273-77.CrossRefGoogle ScholarPubMed
27.Leal, M., & Lissen, E.Infección por el virus de la hepatitis B en prostitutas: Un problema de la salud pública. Medicina Clinica (Barcelona), 1986, 87, 326-27.Google Scholar
28.Leal, M., Ollero, M., Garcia de Pesquera, F., et al. Prevalencia de marcadores séricos de los virus de la hepatitis AyB en varones homosexuales andaluces. Medicina Clinica (Barcelona), 1985, 84, 757–58.Google Scholar
29.Miranda, M. L., Lissen, E., Vinuesa, M., et al. Hepatitis virica en pacientes hemofilicos tratados con concentrados comerciales de factor VIII y IX. Medicina Clinica (Barcelona), 1985, 84, 516–19.Google ScholarPubMed
30.Moestrup, T., et al. Clinical aspects of Delta infection. British Medical Journal, 1983, 286, 87–89.CrossRefGoogle ScholarPubMed
31.Mulley, A. G., Silverstein, M. D., & Dienstag, J. L.Indications for use of hepatitis-B vaccine, based on cost-effectiveness analysis. New England Journal of Medicine, 1982, 307, 644-52.CrossRefGoogle ScholarPubMed
32.Okada, K., Kamiyama, I., Inomata, M., et al. E antigen and anti-e in the serum of asymptomatic carrier mothers as indicators of positive and negative transmission of hepatitis B virus to their infants. New England Journal of Medicine, 1976, 294, 746–49.CrossRefGoogle ScholarPubMed
33.Remis, R. S., Rossignol, M. A., & Cane, M. A.Hepatitis B infection in a day school for mentally retarded students: Transmission from students to staff. American Journal of Public Health, 1987, 77, 1183–86.CrossRefGoogle Scholar
34.Rivera, F., et al. Análisis costo-beneficia de un programa de vacunatión contra la hepatitis-B en personal sanitario hospitalario. Medicina Clinica (Barcelona), 1984, 83, 611–14.Google Scholar
35.Roumeliotou-Karayannis, A., et al. How often does chronic liver disease follow acute hepatitis-B in adults? Infection, 1985, 13, 174–76.CrossRefGoogle ScholarPubMed
36.Russell, L.Is prevention better than cure? Washington, DC: The Brookings Institution, 1986.Google Scholar
37.Saenz Gonzalez, M. C, et al. (Groupo Español de Estudio de la Hepatitis B). Hepatitis-B en personal hospitalario: Morbilidad, exposición accidental, vacunación, y análisis de costes. Medicina Clinica (Barcelona), 1987, 88, 232–36.Google Scholar
38.Sanchez-Quijano, A., Rivera, F., Lissen, E., et al. Prevalencia de los marcadores séricos del virus B hepatitis en el personal sanitario y no sanitario de un hospital general. Medicina Clinica (Barcelona), 1984, 83, 1–3.Google Scholar
39.Schatz, B. L., Kane, M. A., & Francis, D. P.The economic effects of hepatitis-B in the United States (mimeo). Phoenix, AZ: Centers for Disease Control.Google Scholar
40.Seeff, L. B., Beebe, G. W., Hoofnagle, J. H., et al. A serologic follow-up of the 1942 epidemic of postvaccination hepatitis in the United States Army. New England Journal of Medicine, 1987, 316, 965–70.CrossRefGoogle ScholarPubMed
41.Stevens, C. E., Alter, H. J., Taylor, P. E., et al. Hepatitis B vaccine in patients receiving hemodialysis – Immunogenicity and efficacy. New England Journal of Medicine, 1984, 311, 496–501.CrossRefGoogle ScholarPubMed
42.Subero, R. C., Fernandez, F. C., Castiel, J. F., et al. Estudio de las enfermedades profesionales diagnosticadas en un periodo de cuatro años al personal del hospital clinico de San Carlos de Madrid. N Arch Fac Med, 1984, 42, 153–59.Google Scholar
43.Szmuness, W., Stevens, C. E., Harley, E. J., et al. Hepaptitis B vaccine in medical staff of hemodialysis units–Efficacy and subtype cross-protection. New England Journal of Medicine, 1982, 307, 1481–86.CrossRefGoogle Scholar
44.Torrance, G. W.Measurement of health state utilities for economic appraisal. Journal of Health Economics, 1986, 5, 1–30.CrossRefGoogle ScholarPubMed
45.Viral vaccines and antiviral drugs. WHO Technical Report Series, No. 693. Geneva: WHO, 1983.Google Scholar
46.Weisbrod, B. A., & Huston, J. H. Benefits and costs of human vaccines in developed countries: An evaluative survey. PMA Cost-Effectiveness of Pharmaceuticals, Report 2, 1983.Google Scholar
47.Williams, A.Economics of coronary artery bypass grafting. British Medical Journal, 1985, 291, 326–29.CrossRefGoogle ScholarPubMed
48.Hollinger, F. B.Hepatitis B virus. In Fields, B. N., Knipe, D. M. et al. (eds.), Virology. New York: Raven Press, 1990, 2171–236.Google Scholar