Immunization programme against hepatitis B virus infection in Italy: cost-effectiveness

Economic analysis of the first 20 years of universal hepatitis B vaccination program in Italy

“…The results of that study highlighted that averted costs following the decline of acute hepatitis B cases amounted to 2/3 of the expenditure for vaccination during the first 6 y of immunization. 5 Since the impact of hepatitis B immunization is increasingly evident in the middle-long-term, we could perform a more complete clinical and economic evaluation 20 y after the introduction of the immunization program, starting from the first cost-effectiveness study of Da Villa et al 5 The calculation of all costs incurred and avoided in the first 20 y of implementation seemed a particularly interesting approach, taking into account that many a priori models of preventive interventions forecast future clinical and economic benefits, but very few models are subsequently developed to show the actual impact with real data. For this reason, we performed an a posteriori economic analysis of universal hepatitis B vaccination in Italy, but also projected the further future clinical/economic benefits due to the immunization of our population in the first 20 y of the program.…”

“…effects of vaccination would be obtained only after 15 y of immunization, when savings due to avoided costs for treatments of cirrhosis and hepatocellular carcinoma cases would start to become evident. 5 Therefore, we tried to continue and complete the previous study, as hoped by the Authors, and to confirm the favorable outcomes in a broader time horizon.…”

“…At that time, 64,000 people were affected by chronic viral hepatitis or cirrhosis (prevalence rate 112/100,000) and 3,400 by hepatocellular carcinoma (prevalence rate 5.9/100,000). 5 In 1991, hepatitis B incidence had declined to 5 cases / 100,000 subjects (1, 12 and 4 cases per 100,000 in subjects 0-14, 15-24 and ≥ 25 y-old, respectively), due to several changes in social behavior and improvement of health procedures. In 2010, after 20 y of universal vaccination, the rate of notified cases of hepatitis B had decreased to 0.9 cases/100,000 (0.0, 0.5 and 1.2 cases per 100,000 in subjects 0-14, 15-24 and ≥ 25 y old, respectively).…”

Adefovir dipivoxil nella terapia dell’epatite B cronica: profilo farmacologico clinico ed economico

“…Gli unici dati sul costo sociale della patologia in Italia che siamo stati in grado di reperire provengono da uno studio di costo/efficacia della vaccinazione, condotto da Da Villa et al su dati del 1990 [21]. Questi autori hanno stimato un costo annuale medio per paziente con epatite cronica B di circa 19,5 milioni di lire (attualizzati a 28 milioni del 2000 in una review di Bracco [22]), di cui circa l'80% per costi diretti e 20% per costi indiretti, con un onere annuo complessivo per la società italiana stimato in 2.005 miliardi di lire del 2000.…”

"Hepatite B entre as gestantes atendidas pelo programa do pré-natal da Secretaria Municipal da Saúde da Prefeitura Municipal de Ribeirão Preto: prevalência de marcadores e cuidados prestados aos recém-nascidos"

“…A primeira referência às hepatites virais data de meados do século V a. C. A adoção de programas de imunização universal infantil tem demonstrado uma redução drástica na prevalência da infecção pelo HBV em alguns países, que se reflete não apenas na redução da incidência de doença hepática aguda, mas também na redução da população de portadores crônicos e na mortalidade relacionada à cirrose e carcinoma hepatocelular 10,11,21,25,39,59,63 . Apesar do avanço dos programas de vacinação contra a hepatite B observados nas duas últimas décadas do século XX, mais da metade das crianças no mundo ainda não têm acesso à imunização contra o HBV 61 .…”