COST-EFFECTIVENESS OF UNIVERSAL VACCINATION OF CHILDREN AGAINST HEPATITIS A IN CHILE

Author(s)

Laure Durand, PharmD, MSc, Health Economics manager1, Arnoldo Quezada, MD, Chief of Department of Pediatrics2, Florence Baron-Papillon, PharmD, MA, Health Economics manager1, Laurent Coudeville, PhD, Health Economics Deputy Director1, Leonardo Maggi, MD, Medical Director31Sanofi pasteur, Lyon, France; 2 Faculty of Medicine of University of Chile, Santiago de Chile, Chile; 3 Sanofi pasteur, Santiago de Chile, Providencia, Chile

OBJECTIVES: To evaluate the healthcare and economic impact of routine hepatitis A vaccination of toddlers in Chile. METHODS: We used a dynamic model of hepatitis A infection to evaluate the impact of a two-dose vaccination program, administered at age 12 and 18 months. The model incorporated the changing epidemiology of hepatitis A in Chile and the development of vaccine-induced herd immunity. Our analysis was conducted from the Ministry of Health perspective and an estimation of the societal perspective was done. RESULTS: Vaccination of toddlers rapidly reduced the healthcare burden of hepatitis A. In the base case (95% vaccination coverage, 100-year time horizon, 1% annual decrease in force of infection), the average number of infections fell by 76.6% annually, and associated deaths fell by 59.7%. Even at 50% coverage, the program reduced infection rates substantially. Routine vaccination of toddlers had economic as well as health benefits, saving US$4 984 per life-year gained (base case scenario). The program became cost-saving after 6 years, and its overall cost-effectiveness per life-year gained was largely unaffected by changes in disease-related costs, herd immunity, coverage rate, and annual decrease in force of infection. CONCLUSION: Routine vaccination of toddlers will reduce rates of symptomatic hepatitis A and associated mortality. The cost of the two-dose schedule evaluated here will be less expensive than disease-related costs in the absence of vaccination from the sixth year of its implementation. These findings support the establishment of a routine vaccination program for toddlers in Chile to reduce the healthcare and economic burden of hepatitis A.

Conference/Value in Health Info

2007-09, ISPOR Latin America 2007, Cartagena, Colombia

Value in Health, Vol. 10, No. 6 (November/December 2007)

Code

PIN5

Topic

Economic Evaluation

Topic Subcategory

Cost-comparison, Effectiveness, Utility, Benefit Analysis

Disease

Infectious Disease (non-vaccine), Vaccines

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