The cost-effectiveness of vaccinating chronic hepatitis C patients against hepatitis A1
| Autor: | Allen S. Meyerhoff, R. Jake Jacobs, Raymond S. Koff |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
medicine.medical_specialty
Pediatrics Hepatology Cost–benefit analysis business.industry Cost effectiveness Hepatitis A Infection Gastroenterology Hepatitis A Hepatitis C Chronic liver disease medicine.disease Surgery Vaccination Medicine business health care economics and organizations Cohort study |
| Zdroj: | The American Journal of Gastroenterology. 97:427-434 |
| ISSN: | 1572-0241 0002-9270 |
| Popis: | OBJECTIVES: Although hepatitis A vaccination is recommended for persons with chronic liver disease, the cost-effectiveness of vaccinating patients with chronic hepatitis C virus has not been extensively studied. We evaluated its costs and benefits. METHODS: A Markov model was used to assess cost-effectiveness from the health system and societal perspectives. Costs of hepatitis A screening and vaccination were compared with savings from reduced hepatitis A treatment and work loss to determine net costs of a “screen and vaccinate” strategy. Net costs were compared with longevity gains to assess cost-effectiveness. RESULTS: Based on hypothetical cohorts of 100,000 patients, vaccination would reduce the number of hepatitis A cases 63–72%, depending on patient age. Screening and vaccination costs of $5.2 million would be partially offset by $1.5–$2.8 million reductions in hepatitis A treatment costs and $0.2–$1.0 million reductions in work loss costs. From the health system perspective, vaccination would cost $22,256, $50,391, and $102,064 per life-year saved for patients vaccinated at ages 30, 45, and 60 yr, respectively. Cost-effectiveness ratios improve when work loss prevention is considered. Results are most sensitive to hepatitis A infection and hospitalization rates, and the rate used to discount future benefits to their present values. CONCLUSIONS: Hepatitis A vaccination of chronic hepatitis C patients would substantially reduce morbidity and mortality in all age groups examined. Consistent with other medical interventions for chronic hepatitis C patients, cost-effectiveness is most favorable for younger patients. |
| Databáze: | OpenAIRE |
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