OBJECTIVE: To conduct a cost-effectiveness analysis of a universal childhood hepatitis A vaccination program in Brazil. METHODS: An age and time-dependent dynamic model was developed to estimate the incidence of hepatitis A for 24 years. The analysis was run separately according to the pattern of regional endemicity, one for South+Southeast (low endemicity) and one for the North+Northeast+Midwest (intermediate endemicity). The decision analysis model compared universal childhood vaccination with current program of vaccinating high risk individuals. Epidemiologic and cost estimates were based on data from a nationwide seroprevalence survey of viral hepatitis, primary data collection, National Health Information Systems and literature. The analysis was conducted from both the health system and societal perspectives. Costs are expressed in 2008 Brazilian currency (Real). RESULTS: A universal immunization program would have a significant impact on disease epidemiology in all regions, resulting in 64% reduction in the number of cases of icteric hepatitis, 59% reduction in deaths for the disease and a 62% decrease of life years lost, in a national perspective. With a vaccine price of R$16.89 (US$7.23) per dose, vaccination against hepatitis A was a cost-saving strategy in the low and intermediate endemicity regions and in Brazil as a whole from both health system and society perspective. Results were most sensitive to the frequency of icteric hepatitis, ambulatory care and vaccine costs. CONCLUSIONS: Universal childhood vaccination program against hepatitis A could be a cost-saving strategy in all regions of Brazil. These results are useful for the Brazilian government for vaccine related decisions and for monitoring population impact if the vaccine is included in the National Immunization Program.
OBJECTIVE: To conduct a cost-effectiveness analysis of a universal childhood hepatitis A vaccination program in Brazil. METHODS: An age and time-dependent dynamic model was developed to estimate the incidence of hepatitis A for 24 years. The analysis was run separately according to the pattern of regional endemicity, one for South+Southeast (low endemicity) and one for the North+Northeast+Midwest (intermediate endemicity). The decision analysis model compared universal childhood vaccination with current program of vaccinating high risk individuals. Epidemiologic and cost estimates were based on data from a nationwide seroprevalence survey of viral hepatitis, primary data collection, National Health Information Systems and literature. The analysis was conducted from both the health system and societal perspectives. Costs are expressed in 2008 Brazilian currency (Real). RESULTS: A universal immunization program would have a significant impact on disease epidemiology in all regions, resulting in 64% reduction in the number of cases of icteric hepatitis, 59% reduction in deaths for the disease and a 62% decrease of life years lost, in a national perspective. With a vaccine price of R$16.89 (US$7.23) per dose, vaccination against hepatitis A was a cost-saving strategy in the low and intermediate endemicity regions and in Brazil as a whole from both health system and society perspective. Results were most sensitive to the frequency of icteric hepatitis, ambulatory care and vaccine costs. CONCLUSIONS: Universal childhood vaccination program against hepatitis A could be a cost-saving strategy in all regions of Brazil. These results are useful for the Brazilian government for vaccine related decisions and for monitoring population impact if the vaccine is included in the National Immunization Program.
Authors: Leila M M B Pereira; Airton T Stein; Gerusa Maria Figueiredo; Gabriela Perdomo Coral; Ulisses R Montarroyos; Maria Regina Alves Cardoso; Maria Cynthia Braga; Regina Celia Moreira; Alex A Dos Santos; Ricardo Alencar Ximenes Journal: Rev Inst Med Trop Sao Paulo Date: 2021-04-26 Impact factor: 1.846
Authors: Renata Santos Tourinho; Adilson José de Almeida; Livia Melo Villar; Paula Guerra Murat; Gina Jonasson Mousquer Capelin; Ana Rita Coimbra Motta Castro; Vanessa Salete de Paula Journal: Int J Environ Res Public Health Date: 2015-06-30 Impact factor: 3.390
Authors: Saulo A S Mantovani; Breno Matos Delfino; Antonio C Martins; Humberto Oliart-Guzmán; Thasciany M Pereira; Fernando L C C Branco; Athos Muniz Braña; José A Filgueira-Júnior; Ana P Santos; Rayanne A Arruda; Andréia S Guimarães; Alanderson A Ramalho; Cristieli Sergio de Menezes Oliveira; Thiago S Araújo; Nancy Arróspide; Carlos H M L Estrada; Cláudia T Codeço; Mônica da Silva-Nunes Journal: BMC Infect Dis Date: 2015-10-16 Impact factor: 3.090
Authors: Ricardo Arraes de Alencar Ximenes; Celina Maria Turchi Martelli; Marcos Amaku; Ana Marli C Sartori; Patricia Coelho de Soárez; Hillegonda Maria Dutilh Novaes; Leila Maria Moreira Beltrão Pereira; Regina Célia Moreira; Gerusa Maria Figueiredo; Raymundo Soares de Azevedo Journal: PLoS One Date: 2014-05-20 Impact factor: 3.240
Authors: Orlando Mayorga Perez; Martin W G Brinkhof; Matthias Egger; Gert Frösner; Christian Herzog; Marcel Zwahlen Journal: PLoS One Date: 2014-02-11 Impact factor: 3.240