A simplified financial cost-effectiveness analysis of programs for prevention of hepatitis B accidental inoculation among hospital personnel in Thailand.

ABSTRACT

There are four main strategies for preventing medical personnel from hepatitis B infection following accidental inoculation. These are pre-exposure vaccination with and without screening for anti-HBc, post-exposure immunization with and without prior screening and with or without additional vaccination. The average cost for each strategy depends on the prevalence of exposed personnel, the cost and sensitivity of the diagnostic test, and the cumulative risk. In Thailand, if the price of vaccination decreases to US$ 10 or lower, vaccination without screening test will cost least. At present, if the cumulative risk is lower than 1 in 28, the cheapest strategy will be post-exposure immunization alone, even with vaccination. If the cumulative risk is higher than 1 in 2.5, screening test followed by vaccination with anti-HBc will be the most cost-effective.