title: Economic evaluation of vaccination programmes: a consensus statement focusing on viral hepatitis.
abstract: The methods that have been used to estimate the clinical and economic impact of vaccination programmes are not always uniform, which makes it difficult to compare results between economic analyses. Furthermore, the relative efficiency of vaccination programmes can be sensitive to some of the more controversial aspects covered by general guidelines for the economic evaluation of healthcare programmes, such as discounting of health gains and the treatment of future unrelated costs. In view of this, we interpret some aspects of these guidelines with respect to vaccination and offer recommendations for future analyses. These recommendations include more transparency and validation, more careful choice of models (tailored to the infection and the target groups), more extensive sensitivity analyses, and for all economic evaluations (also nonvaccine related) to be in better accordance with general guidelines. We use these recommendations to interpret the evidence provided by economic evaluation applied to viral hepatitis vaccination. We conclude that universal hepatitis B vaccination (of neonates, infants or adolescents) seems to be the most optimal strategy worldwide, except in the few areas of very low endemicity, where the evidence to enable a choice between selective and universal vaccination remains inconclusive. While targeted hepatitis A vaccination seems economically unattractive, universal hepatitis A vaccination strategies have not yet been sufficiently investigated to draw general conclusions.
authors.affiliation: Viral Hepatitis Prevention Board, Antwerp, Belgium. philippe.beutels@ua.ac.be
authors.forename: Philippe
authors.initials: P
authors.lastname: Beutels
authors.forename: W John
authors.initials: WJ
authors.lastname: Edmunds
authors.forename: Fernando
authors.initials: F
authors.lastname: Antoñanzas
authors.forename: G Ardine
authors.initials: GA
authors.lastname: De Wit
authors.forename: David
authors.initials: D
authors.lastname: Evans
authors.forename: Rachel
authors.initials: R
authors.lastname: Feilden
authors.forename: A Mark
authors.initials: AM
authors.lastname: Fendrick
authors.forename: Gary M
authors.initials: GM
authors.lastname: Ginsberg
authors.forename: Henry A
authors.initials: HA
authors.lastname: Glick
authors.forename: Eric
authors.initials: E
authors.lastname: Mast
authors.forename: Marc
authors.initials: M
authors.lastname: Péchevis
authors.forename: Eddy K A
authors.initials: EK
authors.lastname: Van Doorslaer
authors.forename: Ben A
authors.initials: BA
authors.lastname: van Hout
mesh_terms: D000293:Adolescent; D003362:Cost-Benefit Analysis / Q000379:methods; D014943:Global Health; D006302:Health Services Research; D006506:Hepatitis A / Q000191:economics / Q000517:prevention & control*; D022362:Hepatitis A Vaccines / Q000008:administration & dosage / Q000191:economics; D006509:Hepatitis B / Q000191:economics / Q000517:prevention & control*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage / Q000191:economics; D006801:Humans; D017589:Immunization Programs / Q000191:economics*; D007223:Infant; D007231:Infant, Newborn; D017059:Models, Econometric; D016896:Treatment Outcome
chemical_list: D022362:Hepatitis A Vaccines; D017325:Hepatitis B Vaccines