title: Economic analysis of the first 20 years of universal hepatitis B vaccination program in Italy: an a posteriori evaluation and forecast of future benefits.
abstract: Italy was one of the first countries in the world to introduce a routine vaccination program against HBV for newborns and 12-y-old children. From a clinical point of view, such strategy was clearly successful. The objective of our study was to verify whether, at 20 y from its implementation, hepatitis B universal vaccination had positive effects also from an economic point of view. An a posteriori analysis evaluated the impact that the hepatitis B immunization program had up to the present day. The implementation of vaccination brought an extensive reduction of the burden of hepatitis B-related diseases in the Italian population. As a consequence, the past and future savings due to clinical costs avoided are particularly high. We obtained a return on investment nearly equal to 1 from the National Health Service perspective, and a benefit-to-cost ratio slightly less than 1 for the Societal perspective, considering only the first 20 y from the start of the program. In the longer-time horizon, ROI and BCR values were positive (2.78 and 2.46, respectively). The break-even point was already achieved few years ago for the NHS and for the Society, and since then more and more money is progressively saved. The implementation of universal hepatitis B vaccination was very favorable during the first 20 y of adoption, and further benefits will be increasingly evident in the future. The hepatitis B vaccination program in Italy is a clear example of the great impact that universal immunization is able to provide in the medium-long-term when health care authorities are so wise as to invest in prevention.
authors: Department of Health Sciences; University of Florence; Florence, Italy.
authors: Sara
authors: S
authors: Boccalini
authors: Cristina
authors: C
authors: Taddei
authors: Vega
authors: V
authors: Ceccherini
authors: Angela
authors: A
authors: Bechini
authors: Miriam
authors: M
authors: Levi
authors: Dario
authors: D
authors: Bartolozzi
authors: Paolo
authors: P
authors: Bonanni
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003365:Costs and Cost Analysis; D005260:Female; D006291:Health Policy; D006302:Health Services Research; D006509:Hepatitis B / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage / Q000191:economics* / Q000276:immunology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D008297:Male; D014611:Vaccination / Q000191:economics* / Q000379:methods*; D055815:Young Adult
chemical_list: D017325:Hepatitis B Vaccines
keywords: HBV; Italy; chronic hepatitis; cirrhosis; cost-effectiveness; hepatitis B; hepatocellular carcinoma; infection; universal immunization; vaccine
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