PMID- 31566514
OWN - NLM
STAT- MEDLINE
DCOM- 20200226
LR  - 20200226
IS  - 0952-6862 (Print)
IS  - 0952-6862 (Linking)
VI  - 32
IP  - 8
DP  - 2019 Oct 14
TI  - Cost-effectiveness of Hepatitis A vaccination in a developed and developing 
      country.
PG  - 1175-1199
LID - 10.1108/IJHCQA-05-2019-0096 [doi]
AB  - PURPOSE: Hepatitis A is a prevalent disease that is largely preventable by 
      vaccine usage. The vaccine for this illness is highly underused in most regions. 
      In an attempt to find the strategies that are most beneficial in regard to 
      quality-adjusted life years (QALYs) and cost in current environments, the purpose 
      of this paper is to conduct cost-effectiveness analyses to investigate 
      vaccination strategies in a more economically developed country (MEDC), generally 
      known as a "developed" area: the USA, and a less economically developed country 
      (LEDC), generally known as a "developing" area: the state of Rio de Janeiro, 
      Brazil. DESIGN/METHODOLOGY/APPROACH: This study used a dynamic transmission model 
      for comparative effectiveness analyses. The model ran two different scenarios. 
      The two regions studied have different policies and strategies for Hepatitis A 
      vaccination currently, and also used different strategies in 2009. In the USA, a 
      universal vaccination policy was modeled, along with a scenario in which it was 
      removed. In Rio de Janeiro, a no vaccination policy was modeled, along with a 
      scenario in which a universal vaccination policy was effected. FINDINGS: The 
      comparison of resulting incremental cost-effectiveness ratio values to accepted 
      threshold values showed universal vaccination to be cost-effective in both the 
      USA and Rio de Janeiro as compared to no vaccination. When episode and 
      vaccination costs and vaccination efficacy were varied, this still remained true. 
      Universal vaccination was found to result in lower incidence of Hepatitis A in 
      both the USA and Rio de Janeiro. Over the twenty-year time horizon, universal 
      vaccination is projected to prevent 506,945 cases of symptomatic Hepatitis A in 
      the USA and 42,318 cases of Hepatitis A in Rio de Janeiro. Other benefits include 
      a projected increase in cumulative QALYs through the use of universal 
      vaccination. ORIGINALITY/VALUE: This analysis showed universal vaccination to be 
      cost-effective as compared to no vaccination, and portions of the study's 
      approach had not previously been applied in tandem to investigate Hepatitis A 
      interventions. The results may help foster higher compliance rates for Hepatitis 
      A vaccination and even greater per-person economic benefits of universal 
      vaccination, particularly in the USA. The purpose of this study is also to 
      encourage elevated levels of surveillance on age of infection in developing 
      regions and consistent reevaluation utilizing dynamic transmission models in both 
      the USA and Brazil, as well as other rapidly developing regions, in order to 
      prevent future epidemics and costs associated with the disease.
FAU - Ghildayal, Nidhi
AU  - Ghildayal N
AD  - University of Minnesota Twin Cities , Minneapolis, Minnesota, USA.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Int J Health Care Qual Assur
JT  - International journal of health care quality assurance
JID - 8916799
MH  - Adolescent
MH  - Adult
MH  - Brazil/epidemiology
MH  - Child
MH  - Child, Preschool
MH  - *Cost-Benefit Analysis
MH  - *Developing Countries
MH  - Hepatitis A/epidemiology/*prevention & control
MH  - Humans
MH  - Infant
MH  - Middle Aged
MH  - Quality-Adjusted Life Years
MH  - Vaccination/*economics/*trends
MH  - Young Adult
OTO - NOTNLM
OT  - Comparative effectiveness analysis
OT  - Dynamic transmission model
OT  - Hepatitis A vaccination strategies
OT  - Incremental cost-effectiveness ratio
EDAT- 2019/10/01 06:00
MHDA- 2020/02/27 06:00
CRDT- 2019/10/01 06:00
PHST- 2019/10/01 06:00 [entrez]
PHST- 2019/10/01 06:00 [pubmed]
PHST- 2020/02/27 06:00 [medline]
AID - 10.1108/IJHCQA-05-2019-0096 [doi]
PST - ppublish
SO  - Int J Health Care Qual Assur. 2019 Oct 14;32(8):1175-1199. doi: 
      10.1108/IJHCQA-05-2019-0096.