TY - JOUR
T1 - Assessing the Cost-Utility of Universal Hepatitis B Vaccination Among Adults
AU - Hall, Eric W.
AU - Weng, Mark K.
AU - Harris, Aaron M.
AU - Schillie, Sarah
AU - Nelson, Noele P.
AU - Ortega-Sanchez, Ismael R.
AU - Rosenthal, Elizabeth
AU - Sullivan, Patrick S.
AU - Lopman, Ben
AU - Jones, Jeb
AU - Bradley, Heather
AU - Rosenberg, Eli S.
N1 - Publisher Copyright:
© 2022 The Author(s). Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved.
PY - 2022/9/15
Y1 - 2022/9/15
N2 - 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.
AB - 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.
KW - United States
KW - economic evaluation
KW - hepatitis B
KW - vaccination
UR - http://www.scopus.com/inward/record.url?scp=85128893698&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85128893698&partnerID=8YFLogxK
U2 - 10.1093/infdis/jiac088
DO - 10.1093/infdis/jiac088
M3 - Article
C2 - 35260904
AN - SCOPUS:85128893698
SN - 0022-1899
VL - 226
SP - 1041
EP - 1051
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 6
ER -