Cost-Utility Analysis of Expanding Hepatitis B Vaccination among Healthcare Workforce in Ethiopia

Abstract

\n Objective: Three doses of monovalent Hepatitis B vaccinations that given for six months were the most effective as well as a safe way to prevent Hepatitis B viral infection. Ethiopia is one of the countries with high endemicity of Hepatitis B infection. Hence, examining cost-utility analysis of hepatitis B vaccination coverage among healthcare workers in Ethiopia was found the most essential work.\nMethod: : Markov model for expanding vaccination coverage (3 doses of hepatitis B vaccine) was simulated based on the data obtained from black lion specialized hospitals and distinctive works of literature. In Ethiopia, the current vaccine coverage among health care workers accounts for around 14%. Most health workforce (241,250) of Ethiopia was first considered as susceptible with a probability of getting Hepatitis B Virus acutely and 5-10% chance of progressing to chronic Hepatitis B. This study was conducted from a healthcare payer perspective, with 3% discount rate of cost and health outcome as WHO recommendation. Primarily health outcome was measured by QALY gain and ICER. Deterministic analysis and tornado diagrams were employed to manage parameter uncertainty and show a plausible range of cost and effectiveness of variables obtained from published articles and black lion specialized hospitals.\nResult: Current vaccination program is more expensive (US$29.99) with a positive incremental cost of US$ 1.32 and less effective that have negative incremental effectiveness of -0.08 and total life year gains of 28.54 than Expanded Hepatitis B vaccination strategy which costs US$ 28.67 and gives relatively high total life-year gain of 28.62. The resulting ICER was US$ 16.23 per QALY gained. Hence, ICER was a negative current vaccination strategy that was dominated which means that is a more expensive and less effective strategy. One-way sensitivity analysis provides that the current vaccine coverage was dominated for an increase in the risk of infection among unvaccinated individuals.\nConclusion: Increasing current vaccine coverage from 14% to 80% among all Ethiopian all healthcare workforces was the most cost-effective strategy.