Cost-effectiveness of hepatitis A/B vaccine versus hepatitis B vaccine in public sexually transmitted disease clinics

• Published in: Sexually transmitted diseases Vol. 30; no. 11; p. 859
• Main Authors: Jacobs, R Jake, Meyerhoff, Allen S
• Format: Journal Article
• Language: English
• Published: United States 01.11.2003
• Subjects: Adolescent; Adult; Aged; Ambulatory Care Facilities - economics; Cohort Studies; Cost-Benefit Analysis; Female; Hepatitis A - epidemiology; Hepatitis A - prevention & control; Hepatitis B - epidemiology; Hepatitis B - prevention & control; Humans; Male; Middle Aged; Models, Theoretical; Quality-Adjusted Life Years; Sexually Transmitted Diseases - epidemiology; Sexually Transmitted Diseases - prevention & control; United States - epidemiology; Viral Hepatitis Vaccines - economics; United States
• ISSN: 0148-5717; 1537-4521
• DOI: 10.1097/01.OLQ.0000086601.18907.47

Many patients seen at U.S. sexually transmitted disease (STD) clinics are offered hepatitis B vaccination. Substituting hepatitis A/B vaccine would provide additional protection but increase costs. The goal was to estimate the cost effectiveness of hepatitis A/B versus B vaccination for 1,000,000 public STD clinic attenders. A Markov model of hepatitis A outcomes was developed using published literature, U.S. government databases, and expert panel opinion. Added vaccination costs were compared with savings from reduced hepatitis A treatment. Net costs were compared with life-years saved and quality-adjusted life-years (QALYs) gained. Substituting hepatitis A/B vaccine would prevent 2263 overt hepatitis A infections, 292 hospitalizations, 8 premature deaths, and the loss of 281 QALYs. Net health system costs would be $20,892 per life-year saved, or $13,397 per QALY gained. Substituting hepatitis A/B for hepatitis B vaccine would reduce morbidity and mortality in a cost-effective manner.