The First 30 Years of the Universal Hepatitis-B Vaccination-Program in Italy: A Health Strategy with a Relevant and Favorable Economic-Profile

Sara Boccalini (), Benedetta Bonito, Beatrice Zanella, Davide Liedl, Paolo Bonanni and Angela Bechini
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Sara Boccalini: Department of Health Sciences, University of Florence, 50134 Florence, Italy
Benedetta Bonito: Department of Health Sciences, University of Florence, 50134 Florence, Italy
Beatrice Zanella: Department of Health Sciences, University of Florence, 50134 Florence, Italy
Davide Liedl: Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, 50134 Florence, Italy
Paolo Bonanni: Department of Health Sciences, University of Florence, 50134 Florence, Italy
Angela Bechini: Department of Health Sciences, University of Florence, 50134 Florence, Italy

IJERPH, 2022, vol. 19, issue 23, 1-12

Abstract: In 1991, Italy was one of the first countries worldwide to introduce a universal hepatitis-B vaccination for children. Since then, epidemiological data have clearly demonstrated the huge clinical benefits of the vaccination. The aim of this study was to update the favorable economic impact of the hepatitis B virus (HBV) vaccination, 30 years after its implementation. A mathematical model was developed to simulate the clinical/economic impact of the universal HBV-vaccination program versus a hypothetical no-vaccination scenario as a posteriori analysis. We assessed the vaccination benefits over a 30-year-immunization-period (1991–2020), and the following period, 2021–2070. Our data showed a big drop in HBV-related diseases (−82% in infections, chronic disease, and hepatocellular-carcinoma cases), and related costs (−67% in the immunization period and −85% in 2021–2070), attributable to vaccination. The return on investment (ROI) and the benefit-to-cost (BCR) ratios are >1 for the first thirty-year-immunization-period, and are predicted to almost triplicate the economic savings in the period 2021–2070, both for the National Health Service (NHS) and from societal perspectives. Our model confirmed that the implementation of universal HBV-vaccination in Italy during the first 30 years continues to be a cost-saving strategy, and more advantageous effects will be further achieved in the future. The HBV-vaccination strategy greatly expresses a huge impact in both the short- and long-term, and from the clinical and economic point-of-views.

Keywords: HBV; immunization; economic evaluation; cost-saving; cost-benefit; ROI; return on investment; BCR; benefit-to-cost ratio (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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