Cost-benefit analysis of a nationwide inoculation programme against viral hepatitis B in an area of intermediate endemicity.
The large decrease in the cost of vaccines against hepatitis virus B prompts a re-examination of nationwide vaccination campaign strategies. The present study estimates the costs and benefits that would result from a viral hepatitis B prevention programme (with no prior screening) targeted at all under-16-year-olds in Israel in 1990 and only neonates in the period 1991-2034. Israel is situated in an area of intermediate endemicity, where the majority of HBsAg carriers are anti-HBe positive. Such a policy would reduce the number of cases of viral hepatitis B in the vaccinated cohort from 654,000 to 270,000 over the period 1990-2059, yielding a benefit-to-cost ratio of 1.88: 1 for the health services only. Inclusion also of the indirect benefits of reduced work absences and mortality would increase the benefit-to-cost ratio to 2.77:1. Even when the benefits arising from the reduction in hepatocellular carcinoma and liver transplants were excluded, the benefit-to-cost ratio for the health services alone would still be 1.41:1. The adoption of such a nationwide inoculation policy appears therefore to be not only medically but also economically justifiable.
Ginsberg
G M
GM
Department of Data Analysis, Ministry of Health, Jerusalem, Israel.
Berger
S
S
Shouval
D
D
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D006509:Hepatitis B / Q000191:economics / Q000517:prevention & control*; D017325:Hepatitis B Vaccines / Q000191:economics*; D006801:Humans; D007223:Infant; D007557:Israel; D014611:Vaccination / Q000191:economics
D017325:Hepatitis B Vaccines