1. Assessing the Cost-Utility of Universal Hepatitis B Vaccination Among Adults.
- Author
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Hall, Eric W, Weng, Mark K, Harris, Aaron M, Schillie, Sarah, Nelson, Noele P, Ortega-Sanchez, Ismael R, Rosenthal, Elizabeth, Sullivan, Patrick S, Lopman, Ben, Jones, Jeb, Bradley, Heather, and Rosenberg, Eli S
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HEPATITIS B vaccines , *VACCINATION coverage , *QUALITY-adjusted life years , *HEPATITIS B virus , *HEPATITIS B , *MARKOV processes , *HEPATITIS B prevention , *IMMUNIZATION , *HEPATITIS viruses , *COST benefit analysis , *RESEARCH funding , *CARBOCYCLIC acids - Abstract
Background: Although effective against hepatitis B virus (HBV) infection, hepatitis B (HepB) vaccination is only recommended for infants, children, and adults at higher risk. We conducted an economic evaluation of universal HepB vaccination among US adults.Methods: Using a decision analytic model with Markov disease progression, we compared current vaccination recommendations (baseline) with either 3-dose or 2-dose universal HepB vaccination (intervention strategies). In simulated modeling of 1 million adults distributed by age and risk groups, we quantified health benefits (quality-adjusted life years, QALYs) and costs for each strategy. Multivariable probabilistic sensitivity analyses identified key inputs. All costs reported in 2019 US dollars.Results: With incremental base-case vaccination coverage up to 50% among persons at lower risk and 0% increment among persons at higher risk, each of 2 intervention strategies averted nearly one-quarter of acute HBV infections (3-dose strategy, 24.8%; 2-dose strategy, 24.6%). Societal incremental cost per QALY gained of $152 722 (interquartile range, $119 113-$235 086) and $155 429 (interquartile range, $120 302-$242 226) were estimated for 3-dose and 2-dose strategies, respectively. Risk of acute HBV infection showed the strongest influence.Conclusions: Universal adult vaccination against HBV may be an appropriate strategy for reducing HBV incidence and improving resulting health outcomes. [ABSTRACT FROM AUTHOR]- Published
- 2022
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