Study finds Hepatitis B prevention program cost-effective

RESEARCH TRIANGLE PARK, N.C. — The Center for Disease Control and Prevention’s Perinatal Hepatitis B Prevention Program is a cost-effective use of resources, according to a new study by RTI International and the CDC.

The Perinatal Hepatitis B Prevention Program aims to ensure infants born to women who have hepatitis B receive timely preventative medication, complete the hepatitis B vaccine series, and have serologic testing to confirm diagnosis. Preventative medicine, known as postexposure prophylaxis, administered at birth, followed by a three-dose series of the hepatitis B vaccine is 85 to 95 percent effective in preventing a perinatal hepatitis B virus infection.

The study, published online in Pediatrics, is the first study of its kind to focus on the long-term costs and outcomes of preventative medicine established in the Perinatal Hepatitis B Prevention Program. The study evaluated the cost-effectiveness of the program in 2009. The researchers estimated the number of infants born to women who have hepatitis B and compared costs and outcomes to a scenario without program support. 

After comparative analysis, the study indicated that the prevention program led to infant lives saved, calculated in the form of quality-adjusted life years. The results showed the prevention program led to fewer total infections and a cost-effectiveness ratio of $2,600 per quality-adjusted life year. Higher lifetime costs were accrued as a result of the prevention program, but the strategy had considerable better health outcomes than without the program. 

“About 95 percent of pregnant women are currently screened for hepatitis B infection in the United States, but only about 48 percent of those infected are actually captured by the program,” said Carolina Barbosa, Ph.D., research economist at RTI and a co-author of the study. “Our research showed that expanding the CDC program to all infants at risk would still be cost-effective, leading to a smaller amount of perinatal and childhood infections and preventing infant morbidity and mortality due to hepatitis B.” 

Approximately 25,000 infants are born each year to women with hepatitis B in the United States. If no intervention occurs, these infants have a 40 to 90 percent risk of developing an infection. Hepatitis B virus infections can cause premature death from progressive damage to the liver, leading to cirrhosis, cancer of the liver. 

The Advisory Committee on Immunization Practices of the CDC recommends all pregnant women receive a hepatitis B surface antigen screening to ensure that their infants receive preventative treatment if the mother is at-risk.