The cost-effectiveness of introducing hepatitis B vaccine into infant immunization services in Mozambique.
OBJECTIVE
To estimate the cost-effectiveness of introducing hepatitis B vaccine into routine infant immunization services in Mozambique, which took place in the year 2001.


METHODS
A decision analytic model was used to estimate the impact of hepatitis B vaccination. This model was developed for the WHO to estimate the global burden of disease from hepatitis B. Cost data of vaccine delivery and medical treatment related to hepatitis B infection were collected for the analysis.


RESULTS
The introduction of hepatitis B vaccine has increased the annual budget for immunization services by approximately 56%. It is predicted that more than 4000 future deaths are averted annually by the intervention. In the base case scenario, the incremental costs per undiscounted deaths averted amount to US$436, and the costs per undiscounted DALY averted amount to US$36. Since the major impact of hepatitis B vaccination will not start to be evident for at least another 40 years (deaths from hepatitis B mainly occur between 40-60 years of age), the cost per DALY averted rises to US$47, when using a discount rate of 3% on health effects. We found that the monovalent hepatitis B vaccine was considerably more cost-effective than the hepatitis B vaccine in combination with DTP.


CONCLUSIONS
If policy makers value future health benefits equal to current benefits, the cost-effectiveness of infant hepatitis B vaccination is in the range of other primary health care interventions for which similar analysis has been undertaken.
Griffiths
Ulla K
UK
Department of Vaccines and Biologicals, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland. Griffithsu@who.int
Hutton
Guy
G
Das Dores Pascoal
Eva
E
D002353:Carrier State; D002662:Child Health Services / Q000191:economics*; D015331:Cohort Studies; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D017048:Health Care Costs; D006302:Health Services Research; D006509:Hepatitis B / Q000150:complications / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage* / Q000191:economics; D006801:Humans; D017589:Immunization Programs / Q000191:economics* / Q000706:statistics & numerical data; D007223:Infant; D017059:Models, Econometric; D009073:Mozambique / Q000453:epidemiology; D015995:Prevalence; D019057:Quality-Adjusted Life Years
D017325:Hepatitis B Vaccines