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Vaccines for the 21st Century A Tool for Decisionmaking (2000) / Chapter Skim
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Appendix 8: Hepatitis C
Pages 189-194

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From page 189...
... Some countries, such as Japan, have a higher frequency of HCV infection, which is reflected in the high frequency of hepatocellular carcinoma. DISEASE BURDEN Epidemiology For the purposes of the calculations in this report, the committee estimated that there are 150,000 new infections with HCY every year in the United States.
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From page 190...
... See Table A8-1. COST INCURRED BY DISEASE Table A8-2 summarizes the health care costs incurred by HCV infections.
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From page 191...
... Chronic Hepatitis: Slow 15,120 10% course Cirrhosis to carci noma low-grade symptoms 0.97 30.0000 symptomatic phase 0.90 4.0000 terminal carcinoma 0.59 1.0000 premature death 0.00 8.7664 (quality-adjusted life expectancy at onset + 35 years)
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From page 192...
... terminal cirrhosis; 1.0000 100% $5,000 1.0 hospitalization liver failure 1.0000 100% $100 Chronic Hepatitis: Slow course—Cirrhosis to carcinoma 12.0 physician b low-grade symptoms 30.0000 10% $100 0.5 physician a symptomatic phase 4.0000 10% $12,000 0.25 biopsy 4.0000 100% $100 4.0 physician b 4.0000 100% $5,000 0.5 hospitalization terminal carcinoma 1.0000 100% $5,000 1.0 hospitalization 1.0000 100% $100 12.0 physician b Chronic Hepatitis: Rapid, progressive course liver failure: symp- 6.0000 100% $150 12.0 medication c somatic 6.0000 100% $100 6.0 physician b 6.0000 100% $1,000 2.0 diagnostics 6.0000 100% $12,000 0.2 hospitalization liver failure: terminal 1.0000 100% $5,000 l.O hospitalization 1.0000 100% $100 12.0 physician b
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From page 193...
... Using committee assumptions of less-than-ideal efficacy and utilization and including time and monetary costs until a vaccine program is implemented, the annualized present value of the health care costs saved would be $67.9 million. If a vaccine program for HCV were implemented today and the vaccine was 100% efficacious and utilized by 100% of the target population, the annualized present value of the program cost would be $720 million.
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From page 194...
... Using committee assumptions of less-than-ideal utilization and including time and monetary costs until a vaccine program is implemented, the annualized present value of the cost per QALY gained is $7,400. If the target population was all 12-year-olds (assuming 50% utilization)
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Key Terms

  • target population
  • life expectancy
  • committee assumptions
  • using committee
  • liver failure

  • hcv infections
  • including time
  • care costs
  • hcv infection
  • unadjusted life

  • monetary costs
  • qaly gained
  • specialist visits
  • qalys gained
  • progressive course

  • costs saved
  • vaccine development
  • program cost
  • infection experience
  • summarizes vaccine

  • vaccines considered
  • terminal cirrhosis
  • liver cancer
  • antiviral medication
  • chronic hepatitis

  • mild hepatitis
  • committee assumed
  • hcv disease
  • liver disease
  • monthly specialist


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