[Analysis on economic efficacy regarding previous strategies and current recommendations for vaccination against hepatitis B virus in China].
OBJECTIVE
To evaluate the outcome of hepatitis B vaccination strategies performed over the past 14 years and different alternatives recommended for future immunization programs from the point of view of economic efficacy.


METHODS
Methods used would include: process of decision analysis including building the tree; populating the model with parameters; estimating expected cost benefit and effectiveness and deterministic and probabilistic sensitivity and threshold analysis.


RESULTS
In China, over the past 14 years from 1992 to 2005, around 5.348 billion Chinese Yuan were provided for hepatitis B vaccination but the total benefits were 272.825 billion Yuan, with net benefits as 267.477 billion Yuan. The cost for each infection averted was 81.99 Yuan while the benefit of one Yuan being invested had 51.01 Yuan in return. For the future recommendations, data from the study revealed that the priority of hepatitis B vaccination for newborns and vaccinations plus passive immunization of newborns of HBsAg positive mothers were most effective approaches. If the other population as adolescents was included into the vaccination program, then screening for hepatitis B virus markers before accepting the vaccination appeared to be one of the most cost-saving strategies. Sensitivity and threshold analyses showed that hepatitis B virus marker was the most important factor, followed by the cost of vaccine, vaccination coverage and vaccine efficacy, in order.


CONCLUSIONS
Routine vaccination of infants in successive birth cohorts to prevent HBV transmission was a cost-effective strategy administrated over the past 14 years in China. In the following years, the immunization of newborns was still the preferential strategy from a societal perspective. However, vaccination provided to other population including adolescents seemed economically less attractive.
Zhang
Shun-xiang
SX
Shenzhen Center for Disease Control and Prevention, Shenzhen 518020, China.
Dang
Ru-bo
RB
Zhang
Wei-dong
WD
Liang
Xiao-feng
XF
Cui
Fu-qiang
FQ
D002681:China; D003362:Cost-Benefit Analysis / Q000191:economics; D003663:Decision Trees; D006509:Hepatitis B / Q000191:economics* / Q000276:immunology / Q000517:prevention & control*; D017325:Hepatitis B Vaccines / Q000191:economics* / Q000276:immunology; D006801:Humans; D018803:Models, Economic
D017325:Hepatitis B Vaccines