VACCINATION AGAINST HEPATITIS-B VIRUS IN SPAIN - A COST-EFFECTIVENESSANALYSIS

A cost-effectiveness analysis was made to determine the effectiveness of the following strategies of mass immunization with the new recombin ant vaccine against the hepatitis B virus in Spain: vaccination of ado lescents, newborns, both populations, and vaccination plus passive imm unization of newborns of HBsAg positive mothers. Decision trees suppor ted on Markov models with Monte Carlo simulation have been used for th e calculation of costs of the disease and a mathematical model of diff erential equations was used for the simulation of the potential effect iveness of vaccination. The costs considered were those associated wit h the vaccination and travel of subjects, diagnosis, and treatment of the disease. The results are presented as additional cost or saving pe r case of infection prevented. In all assumptions, results showed that the most effective strategy for mass vaccination was the combination of vaccinating all adolescents together with active and passive immuni zation of children born to HBsAg positive mothers. (C) 1997 Elsevier S cience Ltd.