A team from Alexandria, Virginia, USA, evaluated the cost-effectiveness of vaccinating chronic hepatitis C patients against hepatitis A.
A Markov model was used to assess cost-effectiveness from the health system and societal perspectives.
Costs of hepatitis A screening and vaccination were compared with savings from reduced hepatitis A treatment and work loss. These were used to determine net costs of a "screen and vaccinate" strategy.
The researchers compared net costs with longevity gains, to assess cost-effectiveness.
Based on hypothetical cohorts of 100,000 patients, it was found that vaccination would reduce the number of hepatitis A cases by 63-72%, depending on patient age.
| Vaccination would reduce number of hepatitis A cases by 63-72%.
| American Journal of Gastroenterology |
Screening and vaccination costs of $5.2 million would be partially offset by $1.5-$2.8 million reductions in hepatitis A treatment costs and $0.2-$1.0 million reductions in work loss costs.
From the health system perspective, vaccination would cost $22,256, $50,391, and $102,064 per life-year saved for patients vaccinated at ages 30, 45, and 60 years, respectively.
The team found that cost-effectiveness ratios improved when work loss prevention was considered.
Author R. J. Jacobs, of Capitol Outcomes Research, in Alexandria, said on behalf of the group, "Hepatitis A vaccination of chronic hepatitis C patients would substantially reduce morbidity and mortality in all age groups examined."
"Consistent with other medical interventions for chronic hepatitis C patients, cost-effectiveness is most favorable for younger patients," it was concluded.