Evaluation économique de différentes stratégies de vaccination contre l'hépatite B en Suisse

Pascal Zurn and Jean-Pierre Danthine

International Journal of Public Health, 1998, vol. 43, issue 1, S134-S137

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 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. Copyright Birkhäuser Verlag 1998

Date: 1998
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DOI: 10.1007/BF02042198

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