title: Economic evaluation of universal newborn hepatitis B vaccination in China.
abstract: OBJECTIVE
  To estimate the long-term cost-effectiveness of universal newborn hepatitis B vaccination in China, an area of high endemicity.
  
  
  METHODS
  A decision tree was used to describe perinatal hepatitis B virus (HBV) transmission, early infection and impact of vaccination. A Markov model based on 1-year cycles was used to simulate these impacts for the lifetime of a cohort of 10,000,000 infants born in 2002 in China. We compared both cost and health outcomes for two strategies: universal newborn vaccination comprising a timely birth dose (HepB1) with a three-dose vaccination (HepB3) compared with no vaccination. Univariate and probabilistic sensitivity analyses using Monte Carlo simulations were performed to test parameter uncertainty.
  
  
  RESULTS
  Over the cohort's lifetime, 79,966 chronic infections, 37,553 cases of hepatocellular carcinoma (HCC) and 130,796 HBV related deaths would be prevented by universal infant vaccination. The prevalence of HBV infection is reduced by 76%. Over 743,000 life-years and 620,000 quality adjusted life years (QALYs) would be gained and there would be monetary benefits of more than 1 billion US dollars in medical care costs and lost productivity avoided.
  
  
  CONCLUSIONS
  The newborn vaccination programme for Hepatitis B in China both gains QALYs and saves medical care costs. It is important to ensure that timely and comprehensive vaccination programmes continue.
authors: Department of Community Medicine, School of Public Health, the University of Hong Kong, Hong Kong Special Administrative Region, China.
authors: Sandy Qiuying
authors: SQ
authors: Lu
authors: Sarah M
authors: SM
authors: McGhee
authors: Xu
authors: X
authors: Xie
authors: Jinquan
authors: J
authors: Cheng
authors: Richard
authors: R
authors: Fielding
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000517:prevention & control; D002681:China; D003362:Cost-Benefit Analysis; D003663:Decision Trees; D017048:Health Care Costs; D006509:Hepatitis B / Q000453:epidemiology / Q000517:prevention & control*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage / Q000191:economics* / Q000276:immunology; D006515:Hepatitis B virus / Q000276:immunology; D006801:Humans; D007231:Infant, Newborn; D008113:Liver Neoplasms / Q000517:prevention & control; D015233:Models, Statistical; D009010:Monte Carlo Method; D019057:Quality-Adjusted Life Years; D014611:Vaccination
chemical_list: D017325:Hepatitis B Vaccines