The use of hepatitis a vaccination in Italy: an economic evaluation

We report on the conduct and results of an economic model of two different strategies of vaccination against hepatitis A in Italy. In strategy 1 (universal vaccination), all newborns are vaccinated simultaneously with MMR at 15 months and all 12 year olds are vaccinated with combined hepatitis A and...

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Bibliographic Details
Published in:Vaccine 2003-06, Vol.21 (19), p.2250-2257
Main Authors: Demicheli, Vittorio, Carniglia, Emanuela, Fucci, Stefania
Format: Article
Language:English
Subjects:
Cost-effectiveness analysis
Costs and Cost Analysis
Discount rates
Economic models
Economics
Epidemics
Estimates
Hepatitis
Hepatitis A - economics
Hepatitis A - epidemiology
Hepatitis A - immunology
Hepatitis A vaccine
Hepatitis A Vaccines - economics
Hepatitis A virus
Hospital costs
Humans
Immunization
Immunization - statistics & numerical data
Infant, Newborn
Italy - epidemiology
Sensitivity analysis
Vaccines
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Summary:We report on the conduct and results of an economic model of two different strategies of vaccination against hepatitis A in Italy. In strategy 1 (universal vaccination), all newborns are vaccinated simultaneously with MMR at 15 months and all 12 year olds are vaccinated with combined hepatitis A and B vaccine. In strategy 2 (contacts’ vaccination) only subjects with a close social and spatial relationship with the sick are vaccinated. In strategy 1 costs per avoided case and net costs per avoided case values are always very high. Net costs become very low when newborns and 12 year olds are vaccinated, and become negative (indicating a potential gain) when 12 year olds are vaccinated. From an economic viewpoint, universal vaccination appears recommendable only in epidemic conditions. For strategy 2 our model shows that cost for avoidable case are very low and net costs for avoided case are always negative, showing the potential presence of an absolute benefit. We conclude that in Italy mass vaccination appears economically worthwhile only during epidemics but vaccination of contacts is an economically worthwhile routine measure.
ISSN:0264-410X
1873-2518
DOI:10.1016/S0264-410X(03)00136-1