With hepatitis B infecting as many as 10% of people of Asian descent, operations researchers collaborated with a liver transplant surgeon to develop mathematical models that verified the cost effectiveness of hepatitis B interventions. These interventions now successfully screen, treat, and vaccinate millions of Asian and Pacific Islander adults in the U.S. and millions of children in China, according to a paper in a journal of the Institute for Operations Research and the Management Sciences (INFORMS).
Untreated, hepatitis B can become a chronic, lifelong disease that leads to liver cancer and cirrhosis.
Chinese health officials were considering a program of catch-up vaccinations for children who had not been vaccinated at birth, but were reluctant to commit funds to a widespread hepatitis B catch-up vaccination program until analysis confirmed its cost-effectiveness.
The authors' analysis of the program's cost effectiveness influenced the Chinese government's April 2009 decision to expand free catch-up vaccination to all children in China under the age of 15.
They estimate that this decision could result in almost 170 million children being vaccinated and could prevent almost 8 million acute infections, 400,000 chronic infections, and almost 70,000 deaths. The vaccinations would cost the equivalent of $540 million and save the equivalent of $1.4 billion over the lifetime of these children, for a net present savings of approximately $900 million.
Additionally, they would spare hundreds of thousands of Chinese children from facing a lifetime of discrimination those infected with hepatitis B in China, according to reports, are often denied the right to attend school or enter the workplace.
In the U.S., they evaluated four clinical strategies. Of the four, they concluded that it is most cost-effective to adopt a strategy of screening adult Asian and Pacific Islanders for chronic hepatitis B infection so that those identified can
|Contact: Barry List|
Institute for Operations Research and the Management Sciences