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The Denver school-based adolescent hepatitis B vaccination program: a cost analysis with risk simulation.
R R Deuson1, E J Hoekstra, R Sedjo
1National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Ga. 30333, USA. rgd3@cdc.gov
American Journal of Public Health
|November 30, 1999
Summary
School-based hepatitis B vaccination programs are more cost-effective than health maintenance organization (HMO) programs. This finding highlights the efficiency of school-based delivery for public health initiatives.
Area of Science:
- Public Health
- Health Economics
- Vaccinology
Background:
- Hepatitis B vaccination is crucial for preventing infection.
- Evaluating different vaccine delivery models is essential for optimizing public health resources.
Purpose of the Study:
- To compare the cost-effectiveness of school-based hepatitis B vaccination delivery versus a network health maintenance organization (HMO) program.
Main Methods:
- A cohort of 3359 sixth-grade students in Denver, Colorado, participated.
- Immunization data and program costs (direct and indirect) were collected.
- Simulation methods were used to assess outcome sensitivity.
Main Results:
- The school-based program had a per-dose cost-effectiveness ratio of $31, remaining stable under cost variations.
- The network HMO program's direct cost was $68 per dose, and societal cost was $118.
- There was a less than 5% probability that the HMO program could be more cost-effective than the school-based approach.
Conclusions:
- School-based hepatitis B vaccination programs are significantly more cost-effective than network HMO-based programs.
- Lower vaccine costs and reduced parental work-loss costs contribute to the school program's efficiency.