Cost-Effectiveness of Ensuring Hepatitis B Protection for Previously Vaccinated Healthcare Personnel

Hoerger, Thomas J.; Bradley, Christina; Schillie, Sarah; Reilly, Meredith; Murphy, Trudy V.

doi:10.1086/676865

Cited by 5 publications

(7 citation statements)

References 37 publications

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“…Vaccinating adults aged 20–59 years with diabetes mellitus costs $75,094 per QALY saved; cost-effectiveness ratios increase with age at vaccination ( 149 ). Among previously vaccinated current HCP (including those in training), pre-exposure anti-HBs testing followed by revaccination and retesting (if necessary, based on anti-HBs levels), compared with no intervention, was not considered cost-effective with an incremental cost per QALY saved of $3–$4 million at year one and approximately $800,000 over 10 years ( 150 ).…”

Section: Prophylaxis Against Hbv Infectionmentioning

confidence: 99%

Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices

et al. 2018

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Summary Hepatitis B virus (HBV) is transmitted via blood or sexual contact. Persons with chronic HBV infection are at increased risk for cirrhosis and liver cancer and require medical care. This report updates and summarizes previously published recommendations from the Advisory Committee on Immunization Practices (ACIP) and CDC regarding the prevention of HBV infection in the United States. ACIP recommends testing all pregnant women for hepatitis B surface antigen (HBsAg), and testing HBsAg-positive pregnant women for hepatitis B virus deoxyribonucleic acid (HBV DNA); administration of HepB vaccine and hepatitis B immune globulin (HBIG) for infants born to HBV-infected women within 12 hours of birth, followed by completion of the vaccine series and postvaccination serologic testing; universal hepatitis B vaccination within 24 hours of birth, followed by completion of the vaccine series; and vaccination of children and adolescents aged <19 years who have not been vaccinated previously. ACIP recommends vaccination of adults at risk for HBV infection, including universal vaccination of adults in settings in which a high proportion have risk factors for HBV infection and vaccination of adults requesting protection from HBV without acknowledgment of a specific risk factor. These recommendations also provide CDC guidance for postexposure prophylaxis following occupational and other exposures. This report also briefly summarizes previously published American Association for the Study of Liver Diseasest guidelines for maternal antiviral therapy to reduce perinatal HBV transmission

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Section: Prophylaxis Against Hbv Infectionmentioning

confidence: 99%

Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices

et al. 2018

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“…The inclusion of these cost studies in this Special Issue allows for a detailed description of the methods used to arrive at the estimated lifetime cost per infection for each of these STIs, along with extensive documentation of data sources and assumptions. For HBV, we obtained estimates of the lifetime cost per infection from studies published elsewhere 4,14 ; there is no separate cost study of HBV in this Special Issue. For HPV, we did not apply an estimate of the lifetime cost per infection.…”

Section: Multiplying the Number Of Infections By The Lifetime Cost Pe...mentioning

confidence: 99%

“…Estimates of the average lifetime cost per infection were obtained from cost studies included in this Special Issue for chlamydia, 10 gonorrhea, 10 trichomoniasis, 10 syphilis, 11 genital herpes, 12 and HIV. 13 The cost per HBV infection was obtained from other published sources 4,14 as described in the text. Costs are in 2019 US dollars.…”

Section: Point Estimates and Uncertainty Intervalsmentioning

confidence: 99%

The Estimated Direct Lifetime Medical Costs of Sexually Transmitted Infections Acquired in the United States in 2018

Chesson¹,

Spicknall²,

Bingham

et al. 2021

Sexual Trans Dis

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Background:We estimated the lifetime medical costs attributable to sexually transmitted infections (STIs) acquired in 2018, including sexually acquired human immunodeficiency virus (HIV). Methods:We estimated the lifetime medical costs of infections acquired in 2018 in the United States for 8 STIs: chlamydia, gonorrhea, trichomoniasis, syphilis, genital herpes, human papillomavirus (HPV), hepatitis B, and HIV. We limited our analysis to lifetime medical costs incurred for treatment of STIs and for treatment of related sequelae; we did not include other costs, such as STI prevention. For each STI, except HPV, we calculated the lifetime medical cost by multiplying the estimated number of incident infections in 2018 by the estimated lifetime cost per infection. For HPV, we calculated the lifetime cost based on the projected lifetime incidence of health outcomes attributed to HPV infections acquired in 2018. Future costs were discounted at 3% annually.Results: Incident STIs in 2018 imposed an estimated $15.9 billion (25 th -75 th percentile: $14.9-16.9 billion) in discounted, lifetime direct medical costs (2019 US dollars). Most of this cost was due to sexually acquired HIV ($13.7 billion) and HPV ($0.8 billion). STIs in women accounted for about one fourth of the cost of incident STIs when including HIV, but about three fourths when excluding HIV. STIs among 15-to 24-year-olds accounted for $4.2 billion (26%) of the cost of incident STIs.Conclusions: Incident STIs continue to impose a considerable lifetime medical cost burden in the United States. These results can inform health economic analyses to promote the use of cost-effective STI prevention interventions to reduce this burden.

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“…Compared with the conventional vaccine, the additional costs of administering Fendrix Ò to health service staff as a prophylactic against hepatitis B are more than justified if we consider the mean costs entailed in monitoring and treating hepatitis B in health service staff infected through accidental exposure [36,37], combined with the associated sick leave [38][39]. In addition, in the case of accidental infection, the cost of a reported occupational accident would be lower in immunised than in non-immunised subjects [40].…”

Section: Scientific Background and Rationalementioning

confidence: 99%

Vaccination adjuvated against hepatitis B in Spanish National Healthcare System (SNS) workers typed as non-responders to conventional vaccines

Bravo-Grande

Blanco-González

Torre-Robles

et al. 2021

Vaccine

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An interventional, phase 4, single group assignment, without masking (open label), preventive clinical trial was carried out in health workers with biological risk in their tasks, who have been filed as non-responders to conventional vaccination against Hepatitis B. Methods: 67 health workers with biological risk in their tasks, who have been filed as non-responders to conventional vaccination against Hepatitis B, were enrolled in the Clinical Trial. All participants were from 18 years up to 64 years old. Inclusion Criteria: NHS workers -including university students doing their internships in health centres dependent on the National Health System (inclusion of students is regulated and limited by specific instructions on labour prevention in each autonomous community)-classified as non-responders. The criteria defining them as non-responders to the conventional hepatitis B vaccine is anti HBsAb titers < 10 mUI/ml following the application of six doses of conventional vaccine at 20 lg doses (two complete guidelines). The objective of this study was to provide Health workersstaff with an additional protection tool against hepatitis B infection, and to evaluate the efficacy of the adjuvanted vaccine in healthy non-responders to conventional hepatitis B vaccine. The primary outcome was the measurement of antibody antiHBs before the first Fendrix Ò dose and a month after the administration of each dose. Other outcome was collection of adverse effects during administration and all those that could be related to the vaccine and that occur within 30 days after each dose. In this study, only one group was assigned. There was no randomization or masking. Results: The participants were recruited between April 13, 2018 and October 31, 2019. 67 participants were enrolled in the Clinical Trial and included the analyses. The primary immunisation consists of 4 separate 0.5 ml doses of Fendrix Ò , administered at the following schedule: 1 month, 2 months and 6 months from the date of the first dose. Once the positivity was reached in any of the doses, the participant finished the study and was not given the following doses. 68.66% (46 out 67) had a positive response to first

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Cost-Effectiveness of Ensuring Hepatitis B Protection for Previously Vaccinated Healthcare Personnel

Abstract: ICERs may inform decision makers as they decide whether the added cost of the preexposure strategy provides sufficient value in preventing infections.

Cited by 5 publications

References 37 publications

Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices

Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices

The Estimated Direct Lifetime Medical Costs of Sexually Transmitted Infections Acquired in the United States in 2018

Vaccination adjuvated against hepatitis B in Spanish National Healthcare System (SNS) workers typed as non-responders to conventional vaccines

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