Vaccine
Volume 29, Issue 3 pp. 363-612 (10 January 2011)
Economic evaluation of infant and adolescent hepatitis B vaccination in the UK

Original Research Article
Pages 466-475
M. Ruby Siddiqui, Nigel Gay, W. John Edmunds, Mary Ramsay

Abstract
A Markov model of hepatitis B virus (HBV) disease progression in the UK estimated that 81% of predicted HBV-associated morbidity and mortality could be prevented by universal infant vaccination at a cost of approximately £260,000 per QALY gained.

Universal adolescent vaccination would be less effective (45% prevented) and less cost-effective (£493,000 per QALY gained). Higher HBV incidence rates in males and intermediate/high risk ethnic populations meant it was approximately 3 times more cost-effective to vaccinate these groups. At current vaccine costs a selective infant vaccination programme, based on vaccinating intermediate/high risk ethnic populations would not be considered cost effective.

The threshold cost per vaccinated child at which the programme would be considered cost-effective was investigated. Universal infant vaccination would be cost-effective if the average cost of vaccinating each child against HBV, including vaccine and administration costs of all doses, was less than £4.09. Given the low cost of vaccination required to make a universal programme cost-effective the most feasible policy in the UK would be to use a suitably priced combined vaccine that included the other antigens in the current infant vaccination schedule.