Cost of hepatitis B prevention in hospital employees: pre-exposure immunization.

A cost-effectiveness analysis of alternative strategies to prevent hepatitis B in hospital workers was developed to compare pre-exposure immunization with post-exposure prophylaxis. The analysis included the impacts of hepatitis B incidence, employee turnover, strategy efficacy, and medical care expenses to determine the economic effectiveness of immunization and prophylaxis for employees at different risks for hepatitis B exposure. The prophylaxis strategy was found to cost $322 per high-risk employee for a five-year period, while the immunization strategy was found to cost $263 per high-risk employee for a five-year period, for a saving of $59 per employee. Sensitivity analysis demonstrated that pre-exposure immunization remained a cost-effective alternative to post-exposure prophylaxis over a wide range of different model assumptions.