title: Cost-effectiveness of maternal treatment to prevent perinatal hepatitis B virus transmission.
abstract: OBJECTIVE
  To estimate the cost-effectiveness of maternal lamivudine or hepatitis B immune globulin (HBIG) treatment, in addition to standard neonatal immunoprophylaxis, for the prevention of perinatal hepatitis B virus transmission.
  
  
  METHODS
  A decision-tree model was created to estimate the cost-effectiveness of maternal administration of either lamivudine or HBIG in the third trimester to prevent perinatal hepatitis B transmission compared with no maternal treatment. The model was first estimated for each treatment using overall transmission rates, and then stratified by maternal hepatitis B virus DNA viral load.
  
  
  RESULTS
  The model estimated that for each 100 hepatitis B surface antigen positive pregnant women treated with lamivudine, 9.7 cases of chronic hepatitis B virus infections are prevented, with a cost-savings of $5,184 and 1.3 life-years gained per patient treated. For HBIG, 9.5 cases of chronic hepatitis B virus infections are prevented for each 100 pregnant women treated, with a cost-savings of $5,887 and 1.2 life-years gained per patient treated. Under baseline assumptions, lamivudine remains cost-saving unless the reduction in perinatal transmission is less than 18.5%, and HBIG remains cost-saving unless the reduction in perinatal transmission is less than 9.6%.
  
  
  CONCLUSIONS
  In this decision analysis, administration of lamivudine or HBIG to hepatitis B surface antigen positive pregnant women for the prevention of perinatal transmission of hepatitis B is cost-savings across a wide range of assumptions.
  
  
  METHODS
  III.
authors.affiliation: From the Departments of Obstetrics and Gynecology, Pediatrics, and Health Science and Research, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Elizabeth Ramsey
authors.initials: ER
authors.lastname: Unal
authors.forename: Gweneth B
authors.initials: GB
authors.lastname: Lazenby
authors.forename: Anne E
authors.initials: AE
authors.lastname: Lintzenich
authors.forename: Kit N
authors.initials: KN
authors.lastname: Simpson
authors.forename: Roger
authors.initials: R
authors.lastname: Newman
authors.forename: Laura
authors.initials: L
authors.lastname: Goetzl
mesh_terms: D000328:Adult; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D004279:DNA, Viral / Q000032:analysis; D003663:Decision Trees; D005260:Female; D006509:Hepatitis B / Q000191:economics / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D007136:Immunoglobulins / Q000191:economics* / Q000627:therapeutic use; D007231:Infant, Newborn; D019259:Lamivudine / Q000191:economics* / Q000627:therapeutic use; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000191:economics / Q000517:prevention & control*; D011263:Pregnancy Trimester, Third; D018894:Reverse Transcriptase Inhibitors / Q000191:economics* / Q000627:therapeutic use; D019562:Viral Load
chemical_list: D004279:DNA, Viral; D007136:Immunoglobulins; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine