Introducing birth-dose hepatitis B vaccination would be cost effective in Burkina Faso

Abstract

Introducing a programme that delivers the first dose of hepatitis B vaccine within 24 hours of birth in addition to the current 3-dose vaccination programme appears to be a cost-effective option for the prevention of mother-to-child transmission of hepatitis B in Burkina Faso, according to the results of a study published in Vaccine. The researchers used decision-tree and Markov modelling to compare the lifetime costs and outcomes of introducing a birth dose of hepatitis B vaccine to the standard schedule (3-doses beginning at 8 weeks of age) versus the standard schedule alone in the district of Dafra in Burkina Faso. Data were taken from a local demographic survey and other published literature. Costs (2017 US dollars) were taken from a expert interviews. A health system perspective was adopted and two cost-effectiveness thresholds were used: the Burkina Faso per-capita gross domestic product (GDP; $US671 in 2017) and 0.5 times the country’s per-capita GDP ($335). In the base-case analysis with no discounting, introducing a birth dose of hepatitis B vaccine resulted in net cost saving of $18 979 and saved 163 disability-adjusted life years (DALYs), compared with the standard schedule alone. With discounting, birth-dose hepatitis B vaccination resulted in an incremental cost of $554 and 31 DALYs averted, yielding an incremental cost-effectiveness ratio (ICER) of $18 per DALY averted. One-way sensitivity analyses showed that birth-dose vaccination remained cost-effective (at the cost-effectiveness threshold of $671) for all parameter changes. This study provides evidence that adding HepB-BD [birth-dose hepatitis B vaccination] to HepB3 [standard 3-dose hepatitis-B vaccination] would be cost-effective in Burkina Faso a nation where HBV [hepatitis B virus] is highly endemic , conclude the authors.