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


OBJECTIVE
The goal was to estimate the cost effectiveness of hepatitis A/B versus B vaccination for 1,000,000 public STD clinic attenders.


METHODS
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.


RESULTS
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.


CONCLUSIONS
Substituting hepatitis A/B for hepatitis B vaccine would reduce morbidity and mortality in a cost-effective manner.
Jacobs
R Jake
RJ
Capitol Outcomes Research, Inc, Alexandria, VA 22310, USA. jake.jacobs@capitaloutcomesresearch.com
Meyerhoff
Allen S
AS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities / Q000191:economics*; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D005260:Female; D006506:Hepatitis A / Q000453:epidemiology* / Q000517:prevention & control*; D006509:Hepatitis B / Q000453:epidemiology* / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D019057:Quality-Adjusted Life Years; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000517:prevention & control; D014481:United States / Q000453:epidemiology; D014761:Viral Hepatitis Vaccines / Q000191:economics*
D014761:Viral Hepatitis Vaccines