The cost-effectiveness of hepatitis A vaccination in patients with chronic hepatitis C viral infection in the United States

Miguel R. Arguedas, Gustavo R. Heudebert, Michael B. Fallon, Aaron A. Stinnett

Research output: Contribution to journalArticle

34 Scopus citations

Abstract

OBJECTIVE: Hepatitis A vaccination is recommended for patients with chronic hepatitis C. Our aim was to analyze the cost-effectiveness of hepatitis A vaccination in these patients. The specific strategies evaluated were: no vaccination, targeted vaccination, and universal vaccination. METHODS: Clinical estimates were based on published data. Costs estimates were based on published data and institutional Medicare reimbursement rates. Health-related quality-of-life weights were derived from published data and expert estimates. The target population consisted of patients 45 yr of age with chronic hepatitis C followed every 6 months until death. We adopted a societal perspective. RESULTS: Compared with no vaccination, targeted vaccination was associated with an incremental cost-effectiveness ratio of $51,000 per quality-adjusted life-year. The incremental cost-effectiveness ratio of universal vaccination compared with targeted vaccination was $3,900,000 per quality-adjusted life-year. The results were particularly sensitive to the incidence of hepatitis A, probability of fulminant hepatic failure, and costs of hepatitis A antibody screening and vaccination. CONCLUSIONS: Targeted vaccination for hepatitis A in patients with chronic hepatitis C may be a cost-effective strategy to decrease the morbidity and mortality associated with hepatitis A superinfection. Universal vaccination is not a cost-effective alternative to targeted vaccination in this target population.

Original languageEnglish (US)
Pages (from-to)721-728
Number of pages8
JournalAmerican Journal of Gastroenterology
Volume97
Issue number3
DOIs
StatePublished - Apr 4 2002
Externally publishedYes

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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