Cost-Effectiveness Analysis of Hepatitis B Vaccination Strategies to Prevent Perinatal Transmission in North Korea: Selective Vaccination vs. Universal Vaccination

Lee, Dong‐Hoon; Park, Sang Min

doi:10.1371/journal.pone.0165879

Cited by 8 publications

(5 citation statements)

References 28 publications

(45 reference statements)

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“…Lee and Park used a Markov model to establish cost effectiveness of different vaccination strategies for the prevention of perinatal HBV transmission in the DPRK and showed that selective vaccination may be more cost-effective than universal vaccination 15…”

Section: Resultsmentioning

confidence: 99%

Systematic review of evidence on public health in the Democratic People’s Republic of Korea

et al. 2019

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BackgroundEngaging in public health activities in the Democratic People’s Republic of Korea (DPRK, also known as North Korea) offers a means to improve population health for its citizens and the wider region. Such an engagement requires an understanding of current and future needs.MethodsWe conducted a systematic search of five English and eight Korean language databases to identify available literature published between 1988 and 2017. A narrative review of evidence was conducted for five major categories (health systems, communicable diseases (CDs), non-communicable diseases (NCDs), injuries, and reproductive, maternal, newborn and child health (RMNCH) and nutrition).FindingsWe found 465 publications on the DPRK and public health. Of the 253 articles that addressed major disease categories, we found under-representation of publications relative to proportion of disease burden for the two most significant causes: NCDs (54.5% publications vs 72.6% disability adjusted life years (DALYs)) and injuries (0.4% publications vs 12.1% DALYs), in comparison to publications on the third and fourth largest disease burdens, RMNCH and nutrition (30.4% publications vs 8.6% DALYs) and CDs (14.6% publications vs 6.7% DALYs) which were over-represented. Although most disease category articles were on NCDs, the majority of NCD articles addressed mental health of refugees. Only 165 articles addressed populations within the DPRK and among these, we found publication gaps on social and environmental determinants of health, CDs, and NCDs.ConclusionThere are gaps in the public health literature on the DPRK. Future research should focus on under-studied, significant burdens of disease. Moreover, establishing more precise estimates of disease burden and their distribution, as well as analysis on health systems responses aimed at addressing them, can result in improvements in population health.

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Section: Resultsmentioning

confidence: 99%

Systematic review of evidence on public health in the Democratic People’s Republic of Korea

et al. 2019

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“…Community health workers have been used effectively in HIV programmes, 54 distribution of malaria diagnostics and treatment 55 and contraceptives. Other nations have implemented selective vaccination as opposed to universal vaccination and found this to be highly cost effective 56 . This needs to be explored and considered as an alternative in Zimbabwe.…”

Section: Discussionmentioning

confidence: 99%

Progress on the elimination of viral hepatitis in Zimbabwe: A review of the policies, strategies and challenges

Dzingirai

Katsidzira

Matyanga

et al. 2021

Journal of Viral Hepatitis

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Very few low‐income countries have developed national plans to achieve the viral hepatitis elimination targets set in the World Health Organization (WHO) strategy. We reviewed the policy environment, strategies and challenges on the fight against viral hepatitis in Zimbabwe. The review focussed on the Ministry of Health and Child Care (MoHCC) policy documents, strategic plans and reports. We performed key informant interviews to enhance evidence generated from the document review. Twelve documents were reviewed and interviews with 10 key informants were completed. The MoHCC established a technical working group to work towards elimination of viral hepatitis. The technical working group drafted a strategic plan for elimination of viral hepatitis; however, it is still awaiting implementation. Key strategies that are working well include screening of donated blood for transfusion, safe injection practices and hepatitis B virus (HBV) three‐dose vaccination. Current challenges in the drive towards elimination of viral hepatitis include poor to non‐existent surveillance systems, lack of epidemiological data, absence of the HBV vaccine birth dose and lack of systematic screening and treatment services for viral hepatitis. In conclusion, despite political will demonstrated towards achieving viral hepatitis elimination, substantial investment and work are required to implement the strategic plan and realize significant success.

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“…The universal vaccination program was considered to be cost-utility when ICUR ≤ 3 times of the annual per capita GDP (CNY 115,000.00, US$ 17,683.60 in Beijing in 2016) and it was highly cost utility when ICUR does not exceed per capita GDP according to WHO recommendation. 49,50 We further estimated the QALY loss and direct treatment cost of each HB-related disease in different scenarios, to evaluate the health and economic burden due to HBV infection during cohort's lifetime.…”

Section: Cost-utility Analysismentioning

confidence: 99%

Cost-utility analysis of newborn hepatitis B immunization in Beijing

Guo

Yang

Bai

et al. 2020

Human Vaccines & Immunotherapeutics

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Objectives To evaluate cost-utility of universal Hepatitis B vaccination program in the Beijing city (Beijing). Methods A decision-Markov model was constructed to determine the cost-utility of the universal immunization program for infants (universal vaccination program) by comparing with a hypothetic nonvaccination strategy in Beijing. Parameters in models were extracted from Beijing Center for Disease Control and Prevention (CDC) annual work report, Beijing health statistical yearbook, National Health Survey report, Beijing 1% population sample survey report, Beijing Health and Medical Price Monitoring Data Platform, and public literatures. The incremental cost‑utility ratio (ICUR) was used to compare alternative scenarios. One-way sensitivity analysis and probabilistic sensitivity analysis were used to assess parameter uncertainties. Results The universal vaccination program had increased the utility and reduced cost among infants born in 2016 in Beijing. The ICUR was CNY −24,576.61 (US$ −3779.16) per QALY for universal vaccination program comparing with non-vaccination scenario from healthcare perspective. It was estimated that the universal vaccination would save direct medical treatment cost of CNY 2,262,869,173.50 (US$ 347,962,414.43) and prevent loss of 18322.25 QALYs within lifetime of target cohort. Discount rate accounted for the most remarkable influence on ICUR in one-way sensitivity analysis. The result of probabilistic sensitivity analysis illustrated that all of the ICURs were located in the fourth quadrant of the cost-utility incremental plot undergone 5000 times of Monte Carlo simulation. Conclusions Current universal hepatitis B vaccination program in Beijing was highly cost utility. The investment was reasonable for current universal vaccination program in Beijing.

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Cost-Effectiveness Analysis of Hepatitis B Vaccination Strategies to Prevent Perinatal Transmission in North Korea: Selective Vaccination vs. Universal Vaccination

Cited by 8 publications

References 28 publications

Systematic review of evidence on public health in the Democratic People’s Republic of Korea

Systematic review of evidence on public health in the Democratic People’s Republic of Korea

Progress on the elimination of viral hepatitis in Zimbabwe: A review of the policies, strategies and challenges

Cost-utility analysis of newborn hepatitis B immunization in Beijing

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