PharmacoEconomics & Outcomes News 792, p32 - 2 Dec 2017 Best practice for HBV vaccination, screening and care in USA Best practice advice from the American College of Physicians’ High Value Care Task Force and the Centers for Disease Control and Prevention (CDC) on hepatitis B virus (HBV) vaccination, screening and linkage to care has been published in Annals of Internal Medicine. A literature review was conducted of clinical guidelines, systematic reviews, randomised trials and other studies on HBV vaccination, screening and care published between January 2005 and June 2017, and the recommendations and data were used to develop best practice advice statements. The three best practice advice statements were: All unvaccinated adults, including pregnant women, who are at risk of HBV infection due to mucosal, percutaneous or sexual exposure should receive HBV vaccination; along with healthcare and public safety workers at risk of blood exposure; adults with chronic liver disorders, renal failure or HIV infection; people travelling to regions that are HBV-endemic; and adults seeking protection from HBV infection. All people at high risk of HBV should be screened for hepatitis B surface antigen (HbsAg) and antibodies to hepatitis B core antigen and hepatitis B surface antigen. High-risk persons include those born in countries with HBV prevalence ≥2%, men who have sex with men, persons who inject drugs, HIV-positive patients, household or sexual contacts of patients with HBV infection, patients requiring immunosuppressants or with renal failure, blood and tissue donors, patients with hepatitis C infection or with elevated alanine aminotransferase levels, prisoners, pregnant women, and infants born to mothers with HBV. All patients who have tested HBsAg positive should be referred to or provided with counselling and HBV care. Evidence showed that HBV vaccination, screening and care was cost effective or cost saving. Routine HBV vaccination at a sexually transmitted infection clinic was reported to have an incremental cost-effectiveness ratio (ICER) of $3500 per QALY gained compard with no vaccination. ICERs for HBV screening and treatment ranged from $36 088 to $46 489 per QALY gained in some studies. In another study, the ICER for early versus late treatment was $19 505 and $5184 per QALY gained at 10 and 20 years, respectively. "The best practice advice statements in this article amplify and complement existing clinical guidelines by reiterating the importance of hepatitis B vaccination and screening in at-risk persons and linking infected persons to care. Evidence-based strategies that effectively implement this advice are critical to accomplishing the goals of the national hepatitis B elimination plan," said the authors. Abara WE, et al. Hepatitis B Vaccination, Screening, and Linkage to Care: Best Practice Advice From the American College of Physicians and the Centers for Disease Control and Prevention Annals of Internal Medicine : 21 Nov 2017. Available from: URL: http://doi.org/10.7326/M17-1106 803284963 1173-5503/17/0792-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved PharmacoEconomics & Outcomes News 2 Dec 2017 No. 792
PharmacoEconomics & Outcomes News – Springer Journals
Published: Dec 2, 2017
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