The purpose of the study was to compare the cost-effectiveness of the present approach combining universal immunization with hepatitis B immunoglobulin (HBIG) therapy for babies of HBsAg positive mothers to universal vaccination with hepatitis B vaccine only. A decision tree model using a Markov process was built and used to simulate the birth cohort’s lifetime in Zhejiang Province in 2016. In terms of costs and health outcomes, the present policy was compared to universal immunization. Costs were calculated from the standpoint of the health-care system. The number of hepatitis B virus (HBV)-related illnesses and fatalities averted, as well as the number of quality-adjusted life-years (QALYs) gained, were used to calculate the health impacts. The incremental cost effectiveness ratio (ICER) is computed and compared to industry standard willingness-to-pay levels. To examine parameter uncertainty, a one-way sensitivity analysis and a probabilistic sensitivity analysis (PSA) were undertaken. When compared to universal immunization, the present method would prevent 182 acute symptomatic infections, 2215 chronic infections, 872 instances of cirrhosis, 595 cases of hepatocellular carcinoma, and 1,350 HBV-related deaths among the cohort of 624,000 newborns. The present method, which provided not only greater overall QALYs but also cheaper costs, dominated universal immunization. The results were consistent over a wide variety of assumptions.
The present method was less expensive than universal vaccination, and it is suggested that it be maintained in order to significantly reduce the hepatitis B burden.
Reference: https://www.tandfonline.com/doi/full/10.1080/21645515.2019.1688031
