Cost-benefit analysis of hepatitis B vaccination.

Cost effectiveness of hepatitis B vaccination is dependent on the vaccination strategy and the target group. Vaccination with plasma-derived vaccine has been shown to be cost-saving for high-risk groups such as homosexual men, and cost-effective for medium-risk populations such as surgical residents. For the population at large in European countries, vaccination is not a cost-effective use of scarce health care resources. Cost-benefit, cost-effectiveness, and cost-saving studies have made significant contributions to the design of rational vaccination strategies for hepatitis B vaccination programmes. These studies identify the cost of the vaccine and the infection rate to be the most important determinants of cost effectiveness. Studies of benefits and costs of vaccines generally undervalue the net benefits gained by prevention of pain and suffering associated with disease morbidity and mortality. As epidemiological conditions change, and with the introduction of the new generation of recombinant DNA yeast-derived hepatitis B vaccines, there is a need for repeated studies in different countries to identify the risk groups for which the expected net benefit of vaccination is positive. For such studies, improvements in both methodology and epidemiological data are needed.