Cost effectiveness of screening immigrants for hepatitis B

Wong, William; Heathcote, E. Jenny; Krahn, Murray

doi:10.1111/j.1478-3231.2011.02559.x

Cited by 46 publications

(51 citation statements)

References 50 publications

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“…Most studies focused on Canada in general (58.3%), with Quebec (13.3%), Ontario (10.0%) and British Columbia (8.3%) producing the most province-specific vaccine economic evaluations. Economic evaluation of vaccines in Canada considered 20 different diseases including, from most common to least common—influenza (pandemic-2 and seasonal-8) [17–26], human papillomavirus (HPV) [27–35], pneumococcal [36–44], pertussis [45–49], meningitis A, C, Y and/or W135 [50–54], hepatitis B [55–59], varicella [60–62], measles, mumps and/or rubella [63–65], herpes zoster [66, 67], rotavirus [68, 69], rabies [70], hepatitis A [71], tetanus [72], hepatitis C [73], meningitis B [74], group B streptococcus [75], and Escherichia coli [76] (Fig. 2).…”

Section: Resultsmentioning

confidence: 99%

Economic evaluations of vaccines in Canada: a scoping review

Rafferty

Gagnon

Farag

et al. 2017

Cost Eff Resour Alloc

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BackgroundThis study aims to summarise and describe the evolution of published economic evaluations of vaccines in Canada, thereby outlining the current state of this expanding and meaningful research.MethodsUsing Arksey and O’Malley’s scoping review framework we assembled relevant research from both academic and grey literature. Following abstract and full-text review we identified 60 articles to be included in the final analysis.ResultsWe found that since 1988 there has been a steady increase in the number of economic evaluations on vaccines in Canada. Many of these studies focus on the more recently licensed vaccines, such as influenza (16.7%), human papillomavirus (15.0%) and pneumococcal disease (15.0%). Since 2010 economic evaluations of vaccines have shown increased adherence to economic evaluation guidelines (OR = 4.6, CI 1.33, 18.7), suggesting there has been improvement in the consistency and transparency of these studies. However, there remains room for improvement, for instance, we found evidence that studies who stated a conflict of interest are more likely to assert the vaccine of interest was cost-effective (OR = 7.4; CI 1.04, 17.8). Furthermore, most reports use static models that do not consider herd immunity, and only a few evaluate vaccines post-implementation (ex-post) and traveller’s vaccinations.ConclusionResearchers should examine identified research gaps and continue to improve standardization and transparency when reporting to ensure economic evaluations of vaccines best meet the needs of policy-makers, other researchers and the public.Electronic supplementary materialThe online version of this article (doi:10.1186/s12962-017-0069-4) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Economic evaluations of vaccines in Canada: a scoping review

Rafferty

Gagnon

Farag

et al. 2017

Cost Eff Resour Alloc

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“…Gemäß Asylbewerberleistungsgesetz besteht derzeit allerdings nur Anspruch auf die Behandlung akuter Erkrankungen, sodass diese Überwa-chung zumindest in der ersten Zeit nicht finanziert werden würde. Eine Studie sowie eine Metaanalyse aus den Niederlanden und eine Studie aus Kanada konnten zeigen, dass ein Screening auf Hepatitis B zusammen mit frühzeitiger Behandlung bei Migranten kosteneffektiv ist [16][17][18]. Die durch das Screening entstehenden initial höheren Kosten werden im Verlauf durch die geringeren Folgekosten aufgewogen.…”

Section: Diskussionunclassified

“…später eine Lebertransplantation notwendig ist. Es gibt eine geringe Evidenz, dass zumindest in Kanada die Impfung von Migranten nicht kosteneffektiv ist [17]. Schätzungen aus Deutschland liegen hierzu derzeit nicht vor, die generelle Impfung gegen Hepatitis B für Flüchtlinge ist derzeit aber empfohlen.…”

Section: Diskussionunclassified

Aktuelle Seroprävalenz, Impfstatus und prädiktiver Wert der Leberenzyme für Hepatitis B bei Flüchtlingen in Deutschland

Hampel

Solbach

Cornberg

et al. 2016

Bundesgesundheitsbl

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“…Some studies indicate that HBV screening and treatment is cost-effective in US immigrants. Two studies found it cost-effective to screen immigrants from countries with HBV seroprevalence in the range of >2–3% [17, 19]. HBV seroprevalence in U.S.-resettled refugees falls within or above the range of these studies, indicating that a refugee-focused screening and vaccination program may prove economically beneficial compared to vaccination-only programs.…”

Section: Introductionmentioning

confidence: 99%

Cost–benefit comparison of two proposed overseas programs for reducing chronic Hepatitis B infection among refugees: Is screening essential?

Jazwa

Coleman

Gazmararian

et al. 2015

Vaccine

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Background Refugees are at an increased risk of chronic Hepatitis B Virus (HBV) infection because many of their countries of origin, as well as host countries, have intermediate-to-high prevalence rates. Refugees arriving to the US are also at risk of serious sequelae from chronic HBV infection because they are not routinely screened for the virus overseas or in domestic post-arrival exams, and may live in the US for years without awareness of their infection status. Methods A cohort of 26,548 refugees who arrived in Minnesota and Georgia during 2005–2010 was evaluated to determine the prevalence of chronic HBV infection. This prevalence information was then used in a cost-benefit analysis comparing two variations of a proposed overseas program to prevent or ameliorate the effects of HBV infection, titled ‘Screen, then vaccinate or initiate management’ (SVIM) and ‘Vaccinate only’ (VO). The analyses were performed in 2013. All values were converted to US 2012 dollars. Results The estimated six year period-prevalence of chronic HBV infection was 6.8% in the overall refugee population arriving to Minnesota and Georgia and 7.1% in those ≥ 6 years of age. The SVIM program variation was more cost beneficial than VO. While the up-front costs of SVIM were higher than VO ($154,084 vs. $73,758; n=58,538 refugees), the SVIM proposal displayed a positive net benefit, ranging from $24 million to $130 million after only 5 years since program initiation, depending on domestic post-arrival screening rates in the VO proposal. Conclusions Chronic HBV infection remains an important health problem in refugees resettling to the United States. An overseas screening policy for chronic HBV infection is more cost-beneficial than a ‘Vaccination only’ policy. The major benefit drivers for the screening policy are earlier medical management of chronic HBV infection and averted lost societal contributions from premature death.

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Cost effectiveness of screening immigrants for hepatitis B

Abstract: We show that a selective hepatitis B screening programme targeted at all immigrants in Canada is likely to be moderately cost-effective. Identification of silent CHB infection with the offer of treatment when appropriate can extend the lives of immigrants at reasonable cost.

Cited by 46 publications

References 50 publications

Economic evaluations of vaccines in Canada: a scoping review

Economic evaluations of vaccines in Canada: a scoping review

Aktuelle Seroprävalenz, Impfstatus und prädiktiver Wert der Leberenzyme für Hepatitis B bei Flüchtlingen in Deutschland

Cost–benefit comparison of two proposed overseas programs for reducing chronic Hepatitis B infection among refugees: Is screening essential?

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