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APHA Scientific Session and Event Listing

Recorded presentation

Yiqing Hu¹, Greg Scott, Ph D², Lauretta E. Grau, Ph D³, Robert Heimer, Ph D³, Karen H. Seal, M D, M P H⁴, Patricia A. Marshall, Ph D⁵, and Merrill Singer, Ph D⁶. (1) School of Public Health, Yale University, 60 College Street, New Haven, CT 06520, 9178151079, yiqing.hu@yale.edu, (2) Sociology Department, DePaul University, 990 W. Fullerton Ave., Rm. 1118, Chicago, IL 60614, (3) Department of Epidemiology and Public Health, Yale University, PO Box 208034, 60 College St., New Haven, CT 06520, (4) Department of Medicine, University of California San Francisco, San Francisco VA Medical Center, 4150 Clement St., San Francisco, CA 94121, (5) Center for Biomedical Ethics, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106-4976, (6) Hispanic Health Council, 175 Main St., Hartford, CT 06106

Background: Economic evaluation on costs and benefits is one of the important measures of the success of hepatitis B (HBV) vaccination programs. The HBV vaccination targeting injection drug users (IDUs) is anticipated to be cost-beneficial given the high incidence rate (10% per year) in IDUs. Methods: Based on the ongoing three-year randomized controlled trial of syringe exchange-based HBV vaccination program in Chicago, Illinois and Hartford and Bridgeport, Connecticut, the relative costs of operating the program and benefits in terms of savings from prevented acute HBV infections are investigated. A dynamic model is utilized to measure the long-term outcome of acute hepatitis B infection. By taking the perspective of health care sector, this paper only calculates direct costs which include all elements of the campaign and costs directly related to medical treatment on infections. A baseline discount rate of 3% is applied for costs. Sensitivity analysis is conducted to probe the effects of variations in the prevalence and incidence rate of HBV among IDUs, in the rate of successful immunization, in the transition probabilities of disease sequelae, in the costs and in the discount rate. Results: Analysis of successful targeted HBV vaccination in that program proves cost-effective in preventing hepatitis B in IDUs, especially in the condition that the cost of hepatitis B vaccine is decreased and the immunization rate among IDUs is improved. Conclusion: Successful HBV vaccination for IDUs will prove cost-beneficial if expanded to reach susceptible IDUs in other communities through existing syringe exchange programs.

Learning Objectives:

• Evaluate the cost benefit of hepatitis B vaccination campaigns in injecting drug users.
• Identify factors that influence the economic perfomance of hepatitis B vaccination among injecting drug users
• Develop an economical vaccination strategy for hepatitis B prevention in injecting drug users.

Keywords: Injection Drug Users, Hepatitis B

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation