title: Cost-effectiveness analysis of a hepatitis B vaccination catch-up program among children in Shandong Province, China.
abstract: OBJECTIVE
  The aim of the study was to estimate long-term cost‑effectiveness of a hepatitis B vaccination catch-up program among children born between 1994 and 2001 (when they were 8‑15 y old) in Shandong province, China, to provide information for nationwide evaluation and future policy making.
  
  
  METHODS
  We determined the cost-effectiveness of the catch-up program compared with the status quo (no catch-up program). We combined a Decision Tree model and a Markov model to simulate vaccination and clinical progression after hepatitis B virus (HBV) infection. Parameters in the models were from the literature, a field survey, program files, and the National Notifiable Disease Reporting System (NNDRS). The incremental cost‑effectiveness ratio (ICER) was used to compare the 2 alternative strategies. One-way sensitivity analysis, 2-way sensitivity analysis, and probability sensitivity analysis were used to assess parameter uncertainties.
  
  
  RESULTS
  The catch-up program was dominant compared with the status quo. Using a total of 5.53 million doses of vaccines, the catch-up program could prevent 21,865 cases of symptomatic acute hepatitis B, 3,088 carrier states with positive hepatitis B surface antigen (HBsAg), and 812 deaths due to HBV infection. The catch-up program could add 28,888 quality-adjusted life years (QALYs) and save $192.01 million in the targeted population in the future. The models were robust, considering parameter uncertainties.
  
  
  CONCLUSIONS
  The catch-up program in Shandong province among children born between 1994 and 2001 was 'very cost-saving.' It could save life years and reduce total future costs. Our study supported the desirability and impact of such a catch-up program throughout China.
authors.affiliation: a Chinese Center for Disease Control and Prevention ; Beijing , China.
authors.forename: Yuanxi
authors.initials: Y
authors.lastname: Jia
authors.forename: Li
authors.initials: L
authors.lastname: Li
authors.forename: Fuqiang
authors.initials: F
authors.lastname: Cui
authors.forename: Dongliang
authors.initials: D
authors.lastname: Zhang
authors.forename: Guomin
authors.initials: G
authors.lastname: Zhang
authors.forename: Fuzhen
authors.initials: F
authors.lastname: Wang
authors.forename: Xiaohong
authors.initials: X
authors.lastname: Gong
authors.forename: Hui
authors.initials: H
authors.lastname: Zheng
authors.forename: Zhenhua
authors.initials: Z
authors.lastname: Wu
authors.forename: Ning
authors.initials: N
authors.lastname: Miao
authors.forename: Xiaojin
authors.initials: X
authors.lastname: Sun
authors.forename: Li
authors.initials: L
authors.lastname: Zhang
authors.forename: Jingjing
authors.initials: J
authors.lastname: Lv
authors.forename: Feng
authors.initials: F
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D002648:Child; D002681:China; D003362:Cost-Benefit Analysis; D005260:Female; D006509:Hepatitis B / Q000276:immunology / Q000517:prevention & control*; D017325:Hepatitis B Vaccines / Q000191:economics* / Q000627:therapeutic use; D006515:Hepatitis B virus / Q000276:immunology; D006801:Humans; D017589:Immunization Programs / Q000191:economics*; D008297:Male; D008390:Markov Chains; D032541:Mass Vaccination / Q000191:economics*; D019057:Quality-Adjusted Life Years
chemical_list: D017325:Hepatitis B Vaccines
keywords: Anti-HBs, Antibody to Hepatitis B Surface Antigen; CC, Compensated Cirrhosis; CHB, Chronic Hepatitis B; Cost-effectiveness Analysis; DC, Decompensated Cirrhosis; GAVI, Global Alliance on Vaccines and Immunization; GDP, Gross Domestic Product; BCR, Benefit-Cost Ratio; HBV, Hepatitis B Virus; HBsAg, Hepatitis B Surface Antigen; HCC, Hepatocellular Carcinoma; HRQoL, Health-Related Quality of Life; HepB3, 3-dose Coverage of Hepatitis B Vaccine; ICER; ICER, Incremental Cost-Effectiveness Ratio; LT-1, the Year of Liver Transplantation; LT-2, Years after Liver Transplantation; MOH, Ministry of Health; NNDRS, National Notifiable Diseases Reporting System; QALY; QALYs, Quality-Adjusted Life Years; catch-up program; hepatitis B virus; vaccination