Prevention of hepatitis B virus transmission by immunization. An economic analysis of current recommendations

Objective.\=m-\ the outcome of immunization strategies to prevent hepatitis B virus (HBV) transmission. Design and Setting.\=m-\ model was used to determine the incremen-tal effects of the following hepatitis B immunization strategies in a birth cohort re-ceiving immunization services in the public sector: (1) prevention of perinatal HBV infection, (2) routine infant vaccination, or (3) routine adolescent vaccination. Main Outcome Measures.\=m-\ lifetime of the cohort, the reduction in in-fections and medical and work-loss costs of HBV-related liver disease were deter-mined for each strategy and compared with the outcome without immunization. Results.\=m-\ perinatal infection and routine infant vaccination would lower the 4.8 % lifetime risk of HBV infection by at least 68%, compared with a 45% reduction for adolescent vaccination. From a societal perspective, each strategy was found to be cost saving, but was not cost saving with respect to direct medical costs. The estimated cost per year of life saved was $164 to prevent perinatal HBV infection, $1522 for infant vaccination, and $3730 for adolescent vaccination.