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Soz Praventivmed. 1998;43 Suppl 1:S61-4, S134-7.

[Economic evaluation of various hepatitis B vaccination Strategies in Switzerland].

[Article in French, German]

Author information

  • 1Département d'économétrie et d'économie politique, Ecole des HEC, Lausanne.

Abstract

The aim of this study was to assess and compare the costs and epidemiological impact of different vaccination strategies against hepatitis B in Switzerland. A birth cohort of 85,000 individuals was followed over its lifetime using a decision tree analysis. Published data were used to simulate the risk of hepatitis B virus (HBV) infection in the cohort, the consecutive clinical outcomes and the associated costs. Five vaccination scenarios were assessed and compared to the baseline, defined as the high-risk group strategy without prenatal screening. These were: 1. systematic prenatal screening and vaccination of newborns at risk; 2. universal vaccination of infants; 3. universal vaccination of schoolchildren; 4. universal vaccination of infants and schoolchildren; 5. universal vaccination of infants, schoolchildren and adolescents. Results are presented using a 3% annual discounting rate. Systematic prenatal screening reduced the number of chronic infections by 11% and prevented 6 deaths per year. The cost per year of life saved was estimated to be 23,350 CHF. The four universal vaccination scenarios had a much larger impact on the number of chronic infections and deaths prevented (reduction of 68-78%). Costs per year of life saved for universal vaccination ranged from 8820 CHF (infant strategy) to 12,380 CHF (schoolchildren strategy). However, the vaccination of schoolchildren would be as cost-effective as the vaccination of infants using alternative assumptions (a lower compliance for infants compared to schoolchildren or the need for a booster later in the life for infants). The benefit-cost ratio ranged from 1.2 (systematic prenatal screening and vaccination of newborns at risk) to 2.9 (vaccination of infants). Universal vaccination against hepatitis B is more cost-effective than the current selective vaccination strategy of newborns.

PMID:
9833269
[PubMed - indexed for MEDLINE]
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