Cost-effectiveness Analysis of the National Perinatal Hepatitis B Prevention Program

Abstract

METHODS:A decision analytic tree and a long-term Markov model represented the risk of perinatal and childhood infections under different prevention alternatives, and the long-term health and economic consequences of HepB infection. Outcome measures were the number of perinatal infections and childhood infections from infants born to HepB surface antigen-positive women, quality-adjusted life-years (QALYs), lifetime costs, and incremental cost per QALY gained. The health outcomes and total costs of each strategy were compared incrementally. Costs were evaluated from the health care system perspective and expressed in US dollars at a 2010 price base. RESULTS:In all analyses, the PHBPP increased QALYs and led to higher reductions in the number of perinatal and childhood infections than no PHBPP, with a cost-effectiveness ratio of $2602 per QALY. In sensitivity analyses, the cost-effectiveness ratio was robust to variations in model inputs, and there were instances where the program was both more effective and cost saving.CONCLUSIONS: This study indicated that the current PHBPP represents a cost-effective use of resources, and ensuring the program reaches all pregnant women could present additional public health benefits.

Mother‐to‐child transmission of hepatitis B: What more needs to be done to eliminate it around the world?

“…The addition of passive immunisation with HBIG increases the chance of preventing MTCT, from around 70% with BDV alone to 90% when used in combination. HBIG, in addition to BDV, has been found to be cost‐effective in some high or upper middle‐income settings, including China where it has been successfully implemented to high levels . However, the recommended use of HBIG varies between countries.…”

“…HBIG, in addition to BDV, has been found to be cost-effective in some high or upper middle-income settings, including China where it has been successfully implemented to high levels. [41][42][43] However, the recommended use of HBIG varies between countries. For example, in China, UK and USA, it is recommended to all children born to HBsAg-positive mothers.…”

Elimination of Perinatal Hepatitis B: Providing the First Vaccine Dose Within 24 Hours of Birth

“…5 Perinatal hepatitis B-prevention strategies are considered cost-effective, with a cost-effectiveness ratio of $2600 per quality-adjusted life-year. 19 …”

Pharmacoeconomic Analysis of Vaccination in Developed Versus Developing Countries

“…There are some attempts to look into the future-prophylaxis of HPV to prevent future cervical cancer in lowand middle-income countries (13,24), severity-based analyses for influenza pandemics (25), prophylaxis of HBV to prevent future hepatocellular carcinoma (22,26,27) and there are also attempts to look at vaccines under development: malaria (28), dengue (29, 30), and RSV (31). There are also a few studies looking at the potential for the "elimination" of measles (9,(32)(33)(34).…”