[Cost of acute hepatitis A in adults in France]

Seroprophylaxy against hepatitis A has been limited to subjects visiting endemic areas or in contact with acutely infected patients due to the short half-life and high cost of the non-specific immunoglobulins. Inactivated vaccines might offer a better solution, but the real cost factors remain unknown. We undertook this study to determine the cost of acute hepatitis A.

Serum samples from all the non-hospital medical laboratories in the Lyon (France) area were prospectively screened to identify 100 consecutive patients with acute hepatitis (positive for hepatitis A IgM antibodies). A questionnaire was addressed to these 100 subjects 1 year later requesting information on health care expenditures and work loss related to their episode of acute hepatitis A. Imprecise answers were completed by telephone interview.

Answers were obtained from 92 subjects. Confirmation was obtained that the 8 other subjects had not died from their episode of acute hepatitis. Only two patients were hospitalized (for 2 and 4 days). Total mean cost (including medical expenditures and work loss was 11,789 French francs (range 1,524-62,117). Medical consultations and prescriptions comprised 20.0% of the total cost. The real mean cost of work loss (8,423 F) was greater than the cost calculated by the national health service (6,500 F).

This evaluation of the real cost of hepatitis A in non-hospitalized patients should contribute to the definition of an adapted policy for the prevention of hepatitis A.