ECONOMIC-EVALUATION OF DIFFERENT VACCINATION STRATEGIES AGAINST HEPATITIS-B IN SWITZERLAND

The aim of this study was to assets and compare the costs and epidemio logical impact of different vaccination strategies against hepatitis B in Switzerland, A birth cohort of 85000 individuals was followed over its lifetime using a decision tree analysis. Published data were used to simulate the risk of hepatitis B virus (HBV) infection in the coho rt, the consecutive clinical outcomes and the associated costs, Five v accination scenarios were assessed and compared to the baseline, defin ed as the high-risk group strategy without prenatal screening. These w ere: 1. systematic prenatal screening and vaccination of newborns at r isk; 2. universal vaccination of infants; 3. universal vaccination of schoolchildren; 4. universal vaccination of infants and schoolchildren ; 5. universal vaccination of infants schoolchildren and adolescents, Results are presented using a 3% annual discounting rare. Systematic p renatal screening reduced the number of chronic infections by 11% and prevented 6 deaths per year. The cost per year of life saved was estim ated to be 23 350 CHF. The four universal vaccination scenarios had a much larger impact on the number of chronic infections and deaths prev ented (reduction of 68-78%). Costs per year of life saved for universa l vaccination ranged from 8820 CHF (infant strategy) to 12380 CHF (sch oolchildren strategy). However; the vaccination of schoolchildren woul d be as cost-effective as the vaccination of infants using alternative assumptions (a lower compliance far infants compared to schoolchildre n or the need for a booster later in life for infants). The benefit-co st ratio ranged from 1.2 (systematic prenatal screening and vaccinatio n of newborns at risk) to 2.9 (vaccination of infants). Universal vacc ination against hepatitis B is more cost-effective than the current se lective vaccination strategy of newborns.