The utilisation of hepatitis A vaccine 1992-1994.
OBJECTIVE
To assess the utilisation of hepatitis A vaccine in Scotland since it was licensed and also any impact this had on the utilisation of immunoglobulin prophylaxis.


METHODS
Collation and analysis of information obtained from the Pharmacy Practice Division and the Scottish National Blood Transfusion Service (SNBTS).


METHODS
Scotland. 1992 to 1994 inclusive.


METHODS
All supplies/persons for whom hepatitis A vaccine or Human normal immunoglobulin (commercial or via SNBTS) was prescribed or dispensed in Scotland 1992-94.


RESULTS
Hepatitis A vaccine started to be utilised very shortly after it became available. Utilisation has increased progressively since April 1992 with nearly 65,000 "courses' being prescribed in 1994. There has been no obvious impact on the use of immunoglobulin which has increased during this period. New formulations of the vaccine, e.g. paediatric and one dose courses have been rapidly assimilated by practitioners into their practice. Both vaccine and immunoglobulin utilisation follow a marked seasonal pattern with a peak every June.


CONCLUSIONS
Statistics from the Pharmacy Practice Division proved useful in monitoring utilisation of this prescribed vaccine. The increasing utilisation of hepatitis A vaccine is a significant financial outlay for the NHS in Scotland. There may be significant non-compliance with the recommendations for restricting its use. The cost effectiveness of this immunisation for travellers has been recently called in question. The changing epidemiology of endemic infection is referred to in respect of possible immunisation programmes and the likely decline in efficacy of immunoglobulin. The need for more research on the incidence of hepatitis A antibody in the Scottish population is highlighted.
Sloan
D S
DS
Argyll and Clyde Health Board, Paisley.
D017723:Drug Utilization Review / Q000706:statistics & numerical data*; D004335:Drug and Narcotic Control; D022362:Hepatitis A Vaccines; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012606:Scotland; D012621:Seasons; D014611:Vaccination / Q000706:statistics & numerical data*; D014761:Viral Hepatitis Vaccines / Q000008:administration & dosage*
D022362:Hepatitis A Vaccines; D016756:Immunoglobulins, Intravenous; D014761:Viral Hepatitis Vaccines