Cost effectiveness of hepatitis A/B versus hepatitis B vaccination for US prison inmates.
Hepatitis B immunization is provided in many US prison systems. We examined the cost effectiveness of substituting bivalent hepatitis A/B vaccine in this setting, considering regional variation in hepatitis A risks and the potential for disease transmission by former prisoners. Where hepatitis A rates are >200, 100-200, and <100% the national average, declines in hepatitis A treatment costs would offset 137, 88, and 40% of the bivalent vaccine's added cost. In the three regions considered, cost effectiveness would be US$ <0, 2131, and 22,819 per life-year saved, respectively. Prison-based hepatitis A/B immunization would meet accepted standards of cost effectiveness throughout the US.
Capitol Outcomes Research Inc., 6188 Old Franconia Road, Alexandria, VA 22310, USA; University of California at San Francisco, San Francisco, CA, USA. jake.jacobs@capitoloutcomesresearch.com
R Jake
RJ
Jacobs
Philip
P
Rosenthal
Allen S
AS
Meyerhoff
D000328:Adult; D000367:Age Factors; D003362:Cost-Benefit Analysis; D006506:Hepatitis A / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control; D022362:Hepatitis A Vaccines / Q000191:economics* / Q000276:immunology*; D006509:Hepatitis B / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control; D017325:Hepatitis B Vaccines / Q000191:economics* / Q000276:immunology*; D006801:Humans; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D018803:Models, Economic; D011329:Prisoners; D011330:Prisons / Q000191:economics*; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D014611:Vaccination / Q000191:economics*; D017778:Vaccines, Combined / Q000191:economics / Q000276:immunology
D022362:Hepatitis A Vaccines; D017325:Hepatitis B Vaccines; D017778:Vaccines, Combined