title: A preliminary cost-effectiveness analysis of hepatitis E vaccination among pregnant women in epidemic regions.
abstract: Objective To estimate the cost-effectiveness of hepatitis E vaccination among pregnant women in epidemic regions. Methods A decision tree model was constructed to evaluate the cost-effectiveness of 3 hepatitis E virus vaccination strategies from societal perspectives. The model parameters were estimated on the basis of published studies and experts' experience. Sensitivity analysis was used to evaluate the uncertainties of the model. Results Vaccination was more economically effective on the basis of the incremental cost-effectiveness ratio (ICER< 3 times China's per capital gross domestic product/quality-adjusted life years); moreover, screening and vaccination had higher QALYs and lower costs compared with universal vaccination. No parameters significantly impacted ICER in one-way sensitivity analysis, and probabilistic sensitivity analysis also showed screening and vaccination to be the dominant strategy. Conclusion Screening and vaccination is the most economical strategy for pregnant women in epidemic regions; however, further studies are necessary to confirm the efficacy and safety of the hepatitis E vaccines.
authors.affiliation: a School of Public Health, Southeast University , Nanjing , China.
authors.forename: Yueyuan
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: b Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , China.
authors.forename: Xuefeng
authors.initials: X
authors.lastname: Zhang
authors.affiliation: b Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , China.
authors.forename: Fengcai
authors.initials: F
authors.lastname: Zhu
authors.affiliation: a School of Public Health, Southeast University , Nanjing , China.|c Key Laboratory of Environmental Medicine Engineering, Ministry of Education , Nanjing , China.
authors.forename: Hui
authors.initials: H
authors.lastname: Jin
authors.affiliation: a School of Public Health, Southeast University , Nanjing , China.|c Key Laboratory of Environmental Medicine Engineering, Ministry of Education , Nanjing , China.
authors.forename: Bei
authors.initials: B
authors.lastname: Wang
mesh_terms: D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D058872:Epidemics; D005260:Female; D016751:Hepatitis E / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000191:economics* / Q000517:prevention & control*; D014611:Vaccination / Q000191:economics / Q000706:statistics & numerical data; D014765:Viral Vaccines / Q000008:administration & dosage / Q000191:economics* / Q000276:immunology*
chemical_list: D014765:Viral Vaccines
keywords: cost-effectiveness analysis; decision tree model; hepatitis E vaccines; pregnant women