title: Economic evaluation of infant and adolescent hepatitis B vaccination in the UK.
abstract: A Markov model of hepatitis B virus (HBV) disease progression in the UK estimated that 81% of predicted HBV-associated morbidity and mortality could be prevented by universal infant vaccination at a cost of approximately £ 260,000 per QALY gained. Universal adolescent vaccination would be less effective (45% prevented) and less cost-effective (£ 493,000 per QALY gained). Higher HBV incidence rates in males and intermediate/high risk ethnic populations meant it was approximately 3 times more cost-effective to vaccinate these groups. At current vaccine costs a selective infant vaccination programme, based on vaccinating intermediate/high risk ethnic populations would not be considered cost effective. The threshold cost per vaccinated child at which the programme would be considered cost-effective was investigated. Universal infant vaccination would be cost-effective if the average cost of vaccinating each child against HBV, including vaccine and administration costs of all doses, was less than £ 4.09. Given the low cost of vaccination required to make a universal programme cost-effective the most feasible policy in the UK would be to use a suitably priced combined vaccine that included the other antigens in the current infant vaccination schedule.
authors.affiliation: Health Protection Agency, Centre for Infections, 61 Colindale Avenue, London NW9 5EQ, UK.
authors.forename: M Ruby
authors.initials: MR
authors.lastname: Siddiqui
authors.forename: Nigel
authors.initials: N
authors.lastname: Gay
authors.forename: W John
authors.initials: WJ
authors.lastname: Edmunds
authors.forename: Mary
authors.initials: M
authors.lastname: Ramsay
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control*; D017325:Hepatitis B Vaccines / Q000191:economics* / Q000276:immunology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D006113:United Kingdom / Q000453:epidemiology; D014611:Vaccination / Q000191:economics*; D055815:Young Adult
chemical_list: D017325:Hepatitis B Vaccines