LONG TERM HEALTH AND ECONOMIC IMPACT OF HEPATITIS B VACCINATION IN GEORGIA: A DYNAMIC TRANSMISSION MODELING STUDY
Author(s)
Myat Sandi Min, MPH, MSc, MD1, Josephine Walker, PhD2.
1PhD student, University of Bristol, Bristol, United Kingdom, 2University of Bristol, Bristol, United Kingdom.
1PhD student, University of Bristol, Bristol, United Kingdom, 2University of Bristol, Bristol, United Kingdom.
OBJECTIVES: This study evaluated the long-term health and economic impact of hepatitis B birth dose vaccination (HepB-BD) and three dose infant vaccination (HepB3) implemented in Georgia between 2003 and 2023, including their cost-effectiveness in reducing viral Hepatitis B (HBV) related disease burden and healthcare costs.
METHODS: Two retrospective scenarios from 2003 to 2023 were compared: Scenario S1 with observed HepB-BD and HepB3 coverage and Scenario S2 without vaccination. A dynamic age structured HBV transmission and disease progression model projected HBV related outcomes and healthcare costs through 2050, assuming no vaccination after 2023. Utility values were obtained from a published systematic review. The shorter time horizon to 2050 was selected for policy relevance. UNICEF vaccine and operational costs were estimated at 2.78 USD per child for HepB-BD and 8.34 USD for HepB3. Annual healthcare costs for acute infection, chronic infection, compensated cirrhosis, decompensated cirrhosis, and liver cancer were estimated at 281, 281, 420, 830, and 830 USD, respectively, based on Georgia’s national hepatitis programme, excluding liver transplantation. Costs and QALYs were discounted at 1.5% from a health system perspective.
RESULTS: Between 2003 and 2023, an estimated 930,000 newborns received HepB-BD and 834,000 infants received HepB3. By 2050, Scenario S1 was projected to avert 975,615 life years with HBV related conditions, including 220,278 with acute infection, 719,083 with chronic infection, 26,987 with compensated cirrhosis, 1,426 with decompensated cirrhosis, and 7,841 with hepatocellular carcinoma. Although vaccination cost an additional USD 15.1 million, it reduced healthcare costs by USD 233.6 million, generating net savings of USD 218.4 million and 217,321 QALYs. Scenario S1 was therefore dominant, being both more effective and less costly than no vaccination.
CONCLUSIONS: HBV vaccination in Georgia substantially reduced HBV related disease burden and generated major healthcare cost savings, and should therefore continue to be prioritised to support HBV elimination efforts in Georgia.
METHODS: Two retrospective scenarios from 2003 to 2023 were compared: Scenario S1 with observed HepB-BD and HepB3 coverage and Scenario S2 without vaccination. A dynamic age structured HBV transmission and disease progression model projected HBV related outcomes and healthcare costs through 2050, assuming no vaccination after 2023. Utility values were obtained from a published systematic review. The shorter time horizon to 2050 was selected for policy relevance. UNICEF vaccine and operational costs were estimated at 2.78 USD per child for HepB-BD and 8.34 USD for HepB3. Annual healthcare costs for acute infection, chronic infection, compensated cirrhosis, decompensated cirrhosis, and liver cancer were estimated at 281, 281, 420, 830, and 830 USD, respectively, based on Georgia’s national hepatitis programme, excluding liver transplantation. Costs and QALYs were discounted at 1.5% from a health system perspective.
RESULTS: Between 2003 and 2023, an estimated 930,000 newborns received HepB-BD and 834,000 infants received HepB3. By 2050, Scenario S1 was projected to avert 975,615 life years with HBV related conditions, including 220,278 with acute infection, 719,083 with chronic infection, 26,987 with compensated cirrhosis, 1,426 with decompensated cirrhosis, and 7,841 with hepatocellular carcinoma. Although vaccination cost an additional USD 15.1 million, it reduced healthcare costs by USD 233.6 million, generating net savings of USD 218.4 million and 217,321 QALYs. Scenario S1 was therefore dominant, being both more effective and less costly than no vaccination.
CONCLUSIONS: HBV vaccination in Georgia substantially reduced HBV related disease burden and generated major healthcare cost savings, and should therefore continue to be prioritised to support HBV elimination efforts in Georgia.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE448
Topic
Economic Evaluation, Health Policy & Regulatory, Health Technology Assessment
Disease
Gastrointestinal Disorders, Vaccines