Kosten-effectiviteit van algemene vaccinatie tegen hepatitis B - (interimrapportage)

2.50
Hdl Handle:
http://hdl.handle.net/10029/9468
Title:
Kosten-effectiviteit van algemene vaccinatie tegen hepatitis B - (interimrapportage)
Authors:
Wit GA de; Kretzschmar MEE; Smits LJM; Struijs JN; Postma MJ; Laar MJW van de; Jager JC
Other Titles:
Cost effectiveness of national hepatitis B vaccination: interim report
Abstract:
In the Netherlands vaccination against hepatitis B has up to now targeted risk groups such as homosexual men, prostitutes, injecting drug users and persons working in the medical professions. At present, there is a discussion going on about whether to introduce hepatitis B vaccination into the national immunisation programme, as advised by the WHO in 1992. The RIVM has been asked to support decision makers by providing a cost-effectiveness analysis of such a programme, based on current knowledge of the epidemiology of hepatitis B infection and the consequent health-care costs. We collected information on hepatitis B epidemiology from various sources, ranging from notification data to preliminary results of an ongoing case-control study on hepatitis B transmission. After consulting on the prevalence of HBV carriers in the various risk groups and the impact of demographic factors, such as immigration of carriers from highly endemic regions, we simulated hepatitis B infection in an age-structured population with a dynamic transmission model. We also investigated the effects of universal vaccination using this model. The incidences computed by the model were then used as a basis for a cost-effectiveness analysis that resulted in estimates for the costs per life year gained. One of the major conclusions was that circulation of the virus is kept up only within small risk groups; therefore the prevalence of HBV carriage in the Netherlands is mainly determined by immigration of carriers. As a consequence, the effects of national vaccination on the prevalence of HBV will be marginal and the cost per life year gained high. However, our estimates on the cost per life year gained depend heavily on future costs of vaccination and on discounting of future effects. When future effects are not discounted, a national vaccination campaign will be more cost-effective.

In Nederland wordt momenteel overwogen om alle pasgeborenen tegen hepatitis B in te enten. Het RIVM heeft een onderzoek verricht waarin de kosten en effecten van vaccinatie van pasgeborenen vergeleken wordt met het huidige beleid. Dit is gericht op het vaccineren van risicogroepen, zoals homoseksuele mannen en medewerkers in de gezondheidszorg, en op het screenen van zwangeren. Een van de belangrijkste conclusies van het onderzoek is dat het aantal dragers van het virus in Nederland vooral door immigratie van dragers uit het buitenland bepaald wordt. Na invoering van algemene vaccinatie zal het aantal dragers van het virus in Nederland voorlopig niet erg sterk afnemen. De kosten per gewonnen levensjaar van algemene vaccinatie zijn relatief hoog in vergelijking met andere preventieve gezondheidszorgvoorzieningen. Als de kosten van het vaccin in de toekomst echter gaan dalen zal de kosten-effectiviteit van algemene vaccinatie gunstiger worden.
Affiliation:
CZO; CIE
Publisher:
Rijksinstituut voor Volksgezondheid en Milieu RIVM
Issue Date:
24-May-2000
URI:
http://hdl.handle.net/10029/9468
Additional Links:
http://www.rivm.nl/bibliotheek/rapporten/403505004.html
Language:
nl
Series/Report no.:
RIVM Rapport 403505004
Appears in Collections:
RIVM reports - old archive

Full metadata record

DC FieldValue Language
dc.contributor.authorWit GA deen_US
dc.contributor.authorKretzschmar MEEen_US
dc.contributor.authorSmits LJMen_US
dc.contributor.authorStruijs JNen_US
dc.contributor.authorPostma MJen_US
dc.contributor.authorLaar MJW van deen_US
dc.contributor.authorJager JCen_US
dc.date.accessioned2007-02-27T12:44:55Z-
dc.date.available2007-02-27T12:44:55Z-
dc.date.issued2000-05-24en_US
dc.identifier403505004en_US
dc.identifier.urihttp://hdl.handle.net/10029/9468-
dc.description.abstractIn the Netherlands vaccination against hepatitis B has up to now targeted risk groups such as homosexual men, prostitutes, injecting drug users and persons working in the medical professions. At present, there is a discussion going on about whether to introduce hepatitis B vaccination into the national immunisation programme, as advised by the WHO in 1992. The RIVM has been asked to support decision makers by providing a cost-effectiveness analysis of such a programme, based on current knowledge of the epidemiology of hepatitis B infection and the consequent health-care costs. We collected information on hepatitis B epidemiology from various sources, ranging from notification data to preliminary results of an ongoing case-control study on hepatitis B transmission. After consulting on the prevalence of HBV carriers in the various risk groups and the impact of demographic factors, such as immigration of carriers from highly endemic regions, we simulated hepatitis B infection in an age-structured population with a dynamic transmission model. We also investigated the effects of universal vaccination using this model. The incidences computed by the model were then used as a basis for a cost-effectiveness analysis that resulted in estimates for the costs per life year gained. One of the major conclusions was that circulation of the virus is kept up only within small risk groups; therefore the prevalence of HBV carriage in the Netherlands is mainly determined by immigration of carriers. As a consequence, the effects of national vaccination on the prevalence of HBV will be marginal and the cost per life year gained high. However, our estimates on the cost per life year gained depend heavily on future costs of vaccination and on discounting of future effects. When future effects are not discounted, a national vaccination campaign will be more cost-effective.en
dc.description.abstractIn Nederland wordt momenteel overwogen om alle pasgeborenen tegen hepatitis B in te enten. Het RIVM heeft een onderzoek verricht waarin de kosten en effecten van vaccinatie van pasgeborenen vergeleken wordt met het huidige beleid. Dit is gericht op het vaccineren van risicogroepen, zoals homoseksuele mannen en medewerkers in de gezondheidszorg, en op het screenen van zwangeren. Een van de belangrijkste conclusies van het onderzoek is dat het aantal dragers van het virus in Nederland vooral door immigratie van dragers uit het buitenland bepaald wordt. Na invoering van algemene vaccinatie zal het aantal dragers van het virus in Nederland voorlopig niet erg sterk afnemen. De kosten per gewonnen levensjaar van algemene vaccinatie zijn relatief hoog in vergelijking met andere preventieve gezondheidszorgvoorzieningen. Als de kosten van het vaccin in de toekomst echter gaan dalen zal de kosten-effectiviteit van algemene vaccinatie gunstiger worden.nl
dc.format.extent653000 bytesen_US
dc.format.extent668495 bytes-
dc.format.mimetypeapplication/pdf-
dc.language.isonlen_US
dc.publisherRijksinstituut voor Volksgezondheid en Milieu RIVMen_US
dc.relation.ispartofseriesRIVM Rapport 403505004en_US
dc.relation.urlhttp://www.rivm.nl/bibliotheek/rapporten/403505004.htmlen_US
dc.subject.otherpreventionen
dc.subject.othervaccinationen
dc.subject.othereconomic evaluationen
dc.subject.otherliterature reviewen
dc.subject.othercost-effectiveness-analysisen
dc.subject.otherepidemiologyen
dc.subject.othermathematical modellingen
dc.subject.otherepidemiologyen
dc.subject.othermodellingen
dc.subject.otherhepatitis bnl
dc.subject.otherpreventienl
dc.subject.othervaccinatienl
dc.subject.othereconomische evaluatienl
dc.subject.otherkosten-effectiviteits-analysenl
dc.titleKosten-effectiviteit van algemene vaccinatie tegen hepatitis B - (interimrapportage)en_US
dc.title.alternativeCost effectiveness of national hepatitis B vaccination: interim reporten_US
dc.contributor.departmentCZOen_US
dc.contributor.departmentCIEen_US
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