An economic evaluation of universal pertussis vaccination in Italy.

An economic evaluation was performed of universal acellular pertussis vaccination in Italy, where until recently the overall coverage of pertussis vaccination was estimated at 50%. Over the last two years coverage seems to have increased rapidly. By means of a mathematical simulation model, the consequences of pertussis vaccination in terms of both health effects and economic costs were calculated for a single birth cohort followed for 6 years.

An economic evaluation of hepatitis A vaccination in Dutch military personnel.

We analyzed the cost-effectiveness of hepatitis A vaccination regimens using a mathematical simulation model. Passive immunization and two active vaccination strategies (with and without prior screening) were compared with "doing nothing." Hepatitis A antibodies were determined in 2,325 Dutch marines; other input data were retrieved from published and unpublished sources.

Economic evaluation of pertussis prevention by whole-cell and acellular vaccine in Germany.

Unlabelled: Acellular pertussis vaccines are less reactogenic than whole cell pertussis vaccines, but they are also more expensive. Based on simulation models, we compared the costs and effects of three alternative pertussis vaccination strategies in German children to "no prevention": (1) vaccination with whole-cell vaccine at 45% coverage (vaccine efficacy 90%), (2) vaccination with acellular vaccine at 45% coverage (vaccine efficacy 85%), and (3) vaccination with acellular vaccine at 90% coverage. In the two low coverage scenarios expected annual savings in direct medical costs through prevention of disease were larger for whole-cell than for acellular vaccination (252 vs 216 million DM, respectively).

Costs and benefits of routine varicella vaccination in German children.

This study assessed the costs and benefits of introducing routine varicella vaccination to healthy children in Germany. Three vaccination strategies were compared with that of no prevention: vaccination of all 15-month-old children: vaccination of susceptible 12-year-olds (adolescent); and a combination of strategies (children including catch-up). From a purely economic viewpoint, the adeolescent strategy was optimal: It was the only one that resulted in net direct cost savings.

Economic evaluation of antifungal agents in the treatment of toenail onychomycosis in Germany.

Background: The strategies for the management of onychomycosis have changed since the availability of the newer generation of antifungal agents, particularly, itraconazole and terbinafine. Itraconazole (1-week pulse) therapy may have higher efficacy and an improved adverse-effects profile compared to the continuous therapy regimen.

Objective: We performed a pharmacoeconomic evaluation of the most commonly used treatments in Germany for toenail onychomycosis from a health care payer perspective.

Hepatitis B prevention in Europe: a preliminary economic evaluation.

The World Health Organization (WHO) estimates that about 350 million people in the world are carriers of the hepatitis B virus (HBV), 60 million of whom may die from liver cancer and about 45 million from cirrhosis. In the WHO European Region, which has a total population of 839 million inhabitants, the average number of acute hepatitis B cases reported in 1991 was approximately 160,000, giving an incidence of 19 per 100,000 population. This incidence rate varies from 5 per 100,000 in western Europe to 22 per 100,000 in central Europe and 92 per 100,000 in eastern Europe.

Cost-effectiveness analysis of vaccination against hepatitis A in travellers.

Hepatitis A virus (HAV) infection is a substantial risk for travellers from low endemic countries to high endemic destinations. Costs and effects of alternative options for prevention were compared using formal decision analysis. General indications for the optimal prevention of hepatitis A were derived from a cost-effectiveness analysis.

Recommendations for Prevention of Hepatitis A Based on a Cost-Effectiveness Analysis.

Hepatitis A viral infection poses a substantial risk for travelers from low-endemic countries visiting high-endemic destinations. In this study, the general indications for the optimal prevention of hepatitis A are derived using a cost-effectiveness analysis based on the risk exposure determined by frequency and duration of travel as well as natural immunity. Three possible hepatitis A prevention strategies are compared to no prophylaxis: active immunization; an initial screening for HAV followed by active immunization of susceptible travelers; and passive immunization with immune globulins.

Retrospective estimate of the nursing cost of autonomy impairment and cost benefit in clinical trials: feasibility and application of piracetam in demented elderly patients.

The aims of this study were to determine whether the nursing costs of functional disability could be assessed retrospectively and, if so, whether this method was sensitive enough to show the influence of a treatment on economic costs. Four studies were available for this purpose: three randomized, double-blind, placebo-controlled, clinical trials measuring, among others, the influence of piracetam on activities of daily living (ADL) of elderly demented patients in Italy, Austria, and Belgium, and one large population-based survey measuring the costs of providing basic nursing, hygienic, and therapeutic needs to 6000 elderly according to ADL scores. The items on the different ADL scales used in each trial were recoded to a common denominator, and an overall dependency score was calculated for each patient.

Cost-effectiveness analysis of prenatal screening and vaccination against hepatitis B virus--the case of Belgium.

The study examines the cost-effectiveness of screening pregnant women in Belgium for the presence of hepatitis B virus (HBV) and of vaccinating the newborns if necessary. The alternative strategy considered is 'doing nothing'. The rate of carriership among a sample of pregnant women in Belgium amounts to 0.

Cost-effectiveness analysis of hepatitis A prevention in travellers.

The advent of new vaccines and the changing epidemiology of hepatitis A call for an update of the economic evaluation of costs and benefits associated with the various alternative preventative strategies. A decision-tree-based model has been developed which enables the calculation of expected costs and expected numbers of hepatitis A virus HAV infections based on different intervention strategies. The model is sufficiently generic to allow for the evaluation of both population-wide strategies and strategies targeted at particular risk groups.