title: Cost-effectiveness of hepatitis A vaccination for adults in Belgium.
abstract: Hepatitis A vaccination targeting adults (or adult risk-groups like e.g. travellers, health care workers, soldiers or teachers) could be considered an alternative to a universal infant or adolescent vaccination program in low endemic countries. We estimated the current disease burden of hepatitis A in Belgium, and evaluated whether adult vaccination is cost-effective. We used a Markov cohort model to simulate the costs and effects of (1) vaccination of adults and (2) serological screening of adults and vaccination of susceptibles and compared these with the current situation. The results indicated that these expanded vaccination strategies are not cost-effective in the epidemiological circumstances of a typical low-endemic western country. In order to gain 1 quality-adjusted life year the health care payer would have to pay 185,000€ for vaccination and 223,000€ for screening and vaccination of seronegatives. For adult vaccination to be cost-effective, risk-groups would need to be exposed to a force of infection that is 3.5-4 times higher than currently estimated in the general population; or the total costs of vaccination would have to drop with approximately 75%.
authors.affiliation: Centre for Health Economics Research and Modelling Infectious Diseases, Vaccine and Infectious Disease Institute, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Antwerp, Belgium. Jeroen.Luyten@ua.ac.be
authors.forename: Jeroen
authors.initials: J
authors.lastname: Luyten
authors.forename: Stefaan
authors.initials: S
authors.lastname: Van de Sande
authors.forename: Koen
authors.initials: K
authors.lastname: de Schrijver
authors.forename: Pierre
authors.initials: P
authors.lastname: Van Damme
authors.forename: Philippe
authors.initials: P
authors.lastname: Beutels
mesh_terms: D000328:Adult; D001530:Belgium / Q000453:epidemiology; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D006506:Hepatitis A / Q000191:economics / Q000453:epidemiology* / Q000517:prevention & control; D022362:Hepatitis A Vaccines / Q000191:economics*; D006801:Humans; D008390:Markov Chains; D018803:Models, Economic; D019057:Quality-Adjusted Life Years; D014611:Vaccination / Q000191:economics*
chemical_list: D022362:Hepatitis A Vaccines