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. 2008 Jul-Aug;123(4):504-13.
doi: 10.1177/003335490812300412.

Economic benefits of hepatitis B vaccination at sexually transmitted disease clinics in the U.S

M'Kiaira K Miriti  1 , Kaafee Billah, Cindy Weinbaum, Julie Subiadur, Richard Zimmerman, Paula Murray, Robert Gunn, Joanna Buffington
Affiliations

Economic benefits of hepatitis B vaccination at sexually transmitted disease clinics in the U.S

M'Kiaira K Miriti et al. Public Health Rep. 2008 Jul-Aug.

Abstract

Objective: This study assessed the long-term economic implications of a national program to vaccinate all adults treated at sexually transmitted disease (STD) clinics in a single year.

Methods: A model was developed to track the long-term disease outcomes and costs among a hypothetical cohort of 2 million STD clinic clients accessing services in one year, using data from published sources and demonstration projects at STD clinics in San Diego (California), Illinois, and Denver (Colorado). The model estimated net economic benefits of a routine hepatitis B vaccination policy at STD clinics nationwide compared with no vaccination.

Results: Without a vaccination program, an estimated 237,021 new hepatitis B virus (HBV) infections would occur over the lifetimes of the 2 million STD clinic clients seen in a single year. HBV-related medical costs and productivity losses would be $1.6 billion. In a national program for routine vaccination at STD clinics, 1.3 million adults would be expected to receive at least one vaccine dose, and an estimated 45% of the new HBV infections expected without vaccination would be prevented. The vaccination program would cost $138 million, HBV infections occurring despite the program would cost $878 million, and clients' time and travel would cost $45 million. The net economic benefit (savings) of routine vaccination would be $526 million. If the indirect costs of lost productivity due to HBV infection are not considered, routine vaccination would have a net cost of $28 million.

Conclusions: Estimates from this model suggest a national program for routine hepatitis B vaccination of adults at STD clinics would be a cost saving to society.

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Figures

Figure 1
Figure 1
Hepatitis B vaccination at STD clinics: decision and Markov models aBox with solid borders represents an annual health state, arrows indicate allowed transitions; death from each state not shown separately. Box with dashed borders represents health state only allowed in the first year of the model. bDecompensated cirrhosis includes ascites, variceal hemorrhage, and encephalopathy. STD = sexually transmitted disease HBV = hepatitis B virus
Figure 2
Figure 2
Sensitivity analyses: change in net economic benefit in response to 10% change in model parameter values from base casea aParameter change is an increment unless otherwise indicated. Anti-HBc = antibody to hepatitis B core antigen
See this image and copyright information in PMC

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