Cost-effectiveness of hepatitis A vaccination in Indonesia

Suwantika, Auliya A.; Beutels, Philippe; Postma, Maarten J.

doi:10.4161/hv.29353

Cited by 21 publications

(21 citation statements)

References 25 publications

(37 reference statements)

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“…In upper-middle-income countries, universal childhood vaccination against hepatitis A is often found to be a cost-effective public health intervention (Suwantika et al 2013), in addition to protecting vaccinated children and the adults in their families from the direct and indirect household costs associated with infection. For example, cost-effectiveness analyses have suggested that universal childhood vaccination would be a good investment in countries as diverse as Brazil (Sartori et al 2012), Indonesia (Suwantika et al 2014), and Mexico (Carlos et al 2016). Routine childhood vaccination against hepatitis A has already been introduced in several middleincome countries (WHO 2017).…”

Section: Hepatitis a Predictions For A Globalizing Worldmentioning

confidence: 99%

Globalization and the Changing Epidemiology of Hepatitis A Virus

Jacobsen

2018

Cold Spring Harb Perspect Med

123

170

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Increased economic interdependence, social integration, and other aspects of globalization are contributing to significant changes in hepatitis A epidemiology. Globally, the incidence of hepatitis A virus (HAV) infection is decreasing, the age at midpoint of population immunity (AMPI) is increasing, and the proportion of symptomatic cases is increasing as the average age at infection increases. In low-income countries, HAV remains endemic but improved water and sanitation systems are reducing transmission rates among young children. In high-income countries, most adults remain susceptible to HAV and foodborne outbreaks are becoming more frequent. Middle-income countries have diverse epidemiological profiles, and they play important roles in the global spread of HAV through international trade and travel. Future changes in the epidemiology of hepatitis A will be heavily influenced by globalization processes.

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Section: Hepatitis a Predictions For A Globalizing Worldmentioning

confidence: 99%

Globalization and the Changing Epidemiology of Hepatitis A Virus

Jacobsen

2018

Cold Spring Harb Perspect Med

123

170

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“…The QALYs of infected cases were assessed using field investigation and published literatures, 37,38,42 the state lived without hepatitis A was assigned a maximum utility score 1, and death a minimum 0; score of non-hospitalized patients was 0.77; hospitalized patients had a score of 0.65. There hasn't being life quality investigation for asymptomatic infection by HEV, so we selected the loss of asymptomatic infection's QALYs from hepatitis A (0.01 QALY in children in Suwantika et al 43 ) as one from hepatitis E, due to the unavailability of the latter. However, we assumed the lost for asymptomatic infection as 0.05 QALYs, considering elder people with weak immunity and low resistance in our study.…”

Section: Utility Inputsmentioning

confidence: 99%

Health economic evaluation of immunization strategies of hepatitis E vaccine for elderly population

Cheng

Zhao²,

Zhang

et al. 2017

Human Vaccines & Immunotherapeutics

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Objective This study was conducted to assess the cost-effectiveness of hepatitis E vaccination of elderly population in the sporadic regions in China.Methods We used a decision tree-Markov model to evaluate the cost-effectiveness of 3 kinds of hepatitis E virus vaccination strategies from societal perspectives. Parameter estimates were obtained from published researches and experts' opinion. The time horizon was 16 years, and the discounted rate was 3% annually. Costs are expressed in 2016 US dollars.Results The universal vaccination strategy had an incremental cost-effectiveness ratio (ICER) of US$ 8475.90 per QALY gained versus no vaccination. The implementation of screening and vaccination strategy would have an ICER of US$ 4044.28, compared with no vaccination. The vaccination was costeffective (ICER< 3 times China's per capital gross domestic product/quality-adjusted life years). The QALY of asymptomatic infection, vaccine coverage and vaccine protection are the important parameters impacting the ICER in one-way sensitivity analysis and screening and vaccination being the dominant strategy in probabilistic sensitivity analysis.Conclusion This analysis indicates that screening and vaccination is the most cost-effective hepatitis E intervention strategy of elderly population in sporadic region in China.

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“…9 However, one study in Indonesia revealed that 1-dose schedule performed much better in terms of health economics, with an incremental cost-effectiveness ratio of $4,933 per quality adjusted life years(QALY), compared with $14,568 per QALY for 2-dose schedule. 16 Studies assessing immune persistence achieved by a single dose of inactivated hepatitis A vaccine are limited. 3 The major objective of those studies was to assess the response to a booster dose several years after the first dose, mostly among healthy adult travelers.…”

Section: Discussionmentioning

confidence: 99%

Five-year antibody persistence in children after one dose of inactivated or live attenuated hepatitis A vaccine

Zhang

Zhu

et al. 2017

Human Vaccines & Immunotherapeutics

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In China, both inactivated hepatitis A (HA) vaccine and live attenuated HA vaccine are available. We conducted a trial to evaluate 5-year immune persistence induced by one dose of inactivated or live attenuated HA vaccines in children. Subjects with no HA vaccination history had randomly received one dose of inactivated or live attenuated HA vaccine at 18-60 months of age. Anti-HAV antibody concentrations were measured before vaccination and at the first, second, and fifth year after vaccination. Suspected cases of hepatitis A were monitored during the study period. A total of 332 subjects were enrolled and 182 provided evaluable serum samples at all planned time points. seropositive rate at 5 y was 85.9% in the inactivated HA vaccine group and 90.7% in the live attenuated HA vaccine group. GMCs were 76.3% mIU/ml (95% CI: 61.7 - 94.4) and 66.8mIU/ml (95% CI: 57.8 - 77.3), respectively. No significant difference in antibody persistence between 2 groups was found. No clinical hepatitis A case was reported. A single dose of an inactivated or live attenuated HA vaccine at 18-60 months of age resulted in high HAV seropositive rate and anti-HAV antibody concentrations that lasted for at least 5 y.

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Cost-effectiveness of hepatitis A vaccination in Indonesia

Cited by 21 publications

References 25 publications

Globalization and the Changing Epidemiology of Hepatitis A Virus

Globalization and the Changing Epidemiology of Hepatitis A Virus

Health economic evaluation of immunization strategies of hepatitis E vaccine for elderly population

Five-year antibody persistence in children after one dose of inactivated or live attenuated hepatitis A vaccine

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