Cost-effectiveness of hepatitis B screening in a mental health institution

In 1982, the Ohio Department of Health Screening established guidelines for hepatitis B screening and vaccination for intermediate mental health care facilities. The present study was developed to evaluate the cost-effectiveness of these guidelines. Data from an intermediate mental health care institution in Champaign/Urbana, Illinois, were used. The analysis considered the direct costs and benefits accrued over a 3-year period and a range of transmission rates. At a 3-year transmission rate of 0.030, the screening and vaccination policy cost $7300 per case of hepatitis B avoided (or $345,800 per hepatitis B fatality avoided). At a more likely 3-year transmission rate of 0.271, the screening and vaccination policy cost $300 per case of hepatitis B avoided (or $12,100 per hepatitis B fatality avoided). Either way, the active prevention policy compares very well with the amounts of money spent by the US Government on other life-saving programs. A general cost-effectiveness model is given that can be adapted for institution-specific analyses at other mental health care facilities.