Cost-utility analysis of newborn hepatitis B immunization in Beijing

Abstract

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.

Hepatitis B Vaccination Coverage Rates and Associated Factors: A Community-Based, Cross-Sectional Study Conducted in Beijing, 2019–2020

“…We observed differing hepatitis B vaccination coverage rates among different household registration. A reason for this may be that Beijing was among the first few cities to implement a hepatitis B vaccination policy for newborns since 1992 [16], and Beijing has higher medical resources and better health education compared to other cities. Individuals with confirmed or suspected family cases or knowledge of hepatitis B vaccination had high vaccination rates.…”

“…A previous study showed that Beijing's current vaccination program could significantly reduce the economic burden of HBV-related disease [16]. Here, we aimed to perform a cross-sectional study to explore hepatitis B vaccination coverage rates and related factors among the general population of Beijing for future vaccination strategies.…”

Post‐vaccination serologic testing of infants born to hepatitis B surface antigen‐positive mothers is more cost‐effective in Zhejiang Province, China: A Markov chain analysis

“…39 But in a high vaccine coverage country, the current model is probably sufficient. 20,40 Furthermore, the transition prob- In conclusion, this economic evaluation suggests that the PVST strategy is a more cost-effective choice for infants born to HBsAgpositive mothers than the current strategy. Health policy makers may consider to further promote the PVST projects to protect more high-risk infants.…”

“…Secondly, squaring up to the impact of herd immunity and that the protection of the HBV vaccine would weaken by age, 38 a dynamic model might be considered more realistic in this study 39 . But in a high vaccine coverage country, the current model is probably sufficient 20,40 . Furthermore, the transition probabilities were primarily derived from published literatures, mainly from China and Asian countries.…”

The Global Impact of Hepatitis B Vaccination on Hepatocellular Carcinoma

“…In China, the cost-utility model of the universal vaccination program in 2016 determined a saving of US$3779.16 per quality-adjusted life years (QALY) with universal vaccination compared with non-vaccination and prevented 18,322.25 QALY due to hepatitis B-related complications. This resulted in an estimated saving of US$347,962,414.43 over the lifespan of the target cohort [ 73 ]. Using Taiwanese data, Markov modelling demonstrated that universal vaccination led to societal cost savings of NT$55,201 per year and healthcare-associated cost savings of NT$23,830 per year by reducing long term complications associated with chronic hepatitis B, including HCC [ 74 ].…”