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[Economic evaluation on strategy for preventing mother-to-child transmission of hepatitis B in Zhejiang Province].
- Source :
-
Zhonghua yu fang yi xue za zhi [Chinese journal of preventive medicine] [Zhonghua Yu Fang Yi Xue Za Zhi] 2019 Jul 06; Vol. 53 (7), pp. 706-712. - Publication Year :
- 2019
-
Abstract
- Objective: To evaluate the cost-benefit and cost-effectiveness of current strategy for preventing mother-to-child transmission (PMTCT) of hepatitis B virus. Methods: A decision tree model with the Markov process was developed and simulated over the lifetime of a birth cohort in Zhejiang Province in 2016. The current PMTCT strategy was compared with universal vaccination and non-vaccination. Costs were assessed from social perspective. Benefits were the savings from reduced costs associated with disease and effectiveness were measured by quality-adjusted of life-years (QALY) gained. The net present value (NPV), cost-benefit ratio (BCR) and incremental cost-effectiveness ratio (ICER) were calculated. Univariate and Probabilistic Sensitivity Analyses (PSA) were performed to assess parameter uncertainties. The parameters of costs and utilities value of hepatitis B-related disease came from the results of the field survey, which were obtained by face-to-face questionnaire survey combined with inpatient medical records, including eight county and municipal hospitals in Jinhua, Jiaxing and Taizhou. A total of 626 outpatients and 523 inpatient patients were investigated. The annual total costs of infection was calculated by combining the costs of outpatient and inpatient. Results: The PMTCT strategy showed a net-gain as 38 323.78 CNY per person, with BCR as 21.10, which was higher than 36 357.80 CNY per person and 13.58 respectively of universal vaccination. Compared with universal vaccination, the PMTCT strategy would save 2 787.07 CNY per additional QALY gained for every person, indicating that PMTCT would be cost-saving. The most important parameters that could affect BCR and ICER were the vaccine coverage rate and costs of hepatitis B related diseases respectively. The PSA showed the PMTCT strategy was preferable as it would gain more QALY and save costs. Conclusions: The PMTCT strategy appeared as highly cost-beneficial and highly cost-effective. High vaccination rate was a key factor of high economic value.
- Subjects :
- China
Cost-Benefit Analysis
Female
Hepatitis B economics
Hepatitis B transmission
Hepatitis B Vaccines administration & dosage
Humans
Infant
Infectious Disease Transmission, Vertical economics
Pregnancy
Quality-Adjusted Life Years
Vaccination statistics & numerical data
Hepatitis B prevention & control
Hepatitis B Vaccines economics
Infectious Disease Transmission, Vertical prevention & control
Vaccination economics
Subjects
Details
- Language :
- Chinese
- ISSN :
- 0253-9624
- Volume :
- 53
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Zhonghua yu fang yi xue za zhi [Chinese journal of preventive medicine]
- Publication Type :
- Academic Journal
- Accession number :
- 31288342
- Full Text :
- https://doi.org/10.3760/cma.j.issn.0253-9624.2019.07.010