title: [Use the Markov-decision tree model to optimize vaccination strategies of hepatitis E among women aged 15 to 49].
abstract: Objective:To evaluate the cost-utility of different hepatitis E vaccination strategies in women aged 15 to 49.Methods:The Markov-decision tree model was constructed to evaluate the cost-utility of three hepatitis E virus vaccination strategies. Parameters of the models were estimated on the basis of published studies and experience of experts. Both methods on sensitivity and threshold analysis were used to evaluate the uncertainties of the model.Results:Compared with non-vaccination group, strategy on post-screening vaccination with rate as 100%, could save 0.10 quality-adjusted life years per capital in the women from the societal perspectives. After implementation of screening program and with the vaccination rate reaching 100%, the incremental cost utility ratio (ICUR) of vaccination appeared as 5 651.89 and 6 385.33 Yuan/QALY, respectively. Vaccination post to the implementation of a screening program, the result showed better benefit than the vaccination rate of 100%. Results from the sensitivity analysis showed that both the cost of hepatitis E vaccine and the inoculation compliance rate presented significant effects. If the cost were lower than 191.56 Yuan (RMB) or the inoculation compliance rate lower than 0.23, the vaccination rate of 100% strategy was better than the post-screening vaccination strategy, otherwise the post-screening vaccination strategy appeared the optimal strategy.Conclusion:Post-screening vaccination for women aged 15 to 49 from social perspectives seemed the optimal one but it had to depend on the change of vaccine cost and the rate of inoculation compliance.
authors.affiliation: School of Public Health, Southeast University, Nanjing 210009, China.
authors.forename: Z M
authors.initials: ZM
authors.lastname: Chen
authors.affiliation: School of Public Health, Southeast University, Nanjing 210009, China.
authors.forename: S B
authors.initials: SB
authors.lastname: Ji
authors.affiliation: School of Public Health, Southeast University, Nanjing 210009, China.
authors.forename: X L
authors.initials: XL
authors.lastname: Shi
authors.affiliation: School of Public Health, Southeast University, Nanjing 210009, China.
authors.forename: Y Y
authors.initials: YY
authors.lastname: Zhao
authors.affiliation: Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China.
authors.forename: X F
authors.initials: XF
authors.lastname: Zhang
authors.affiliation: School of Public Health, Southeast University, Nanjing 210009, China.
authors.forename: H
authors.initials: H
authors.lastname: Jin
mesh_terms: D000293:Adolescent; D000328:Adult; D002681:China / Q000453:epidemiology; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D003663:Decision Trees; D005260:Female; D016751:Hepatitis E / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D008390:Markov Chains; D008875:Middle Aged; D008962:Models, Theoretical; D019057:Quality-Adjusted Life Years; D014611:Vaccination / Q000191:economics / Q000706:statistics & numerical data*; D014761:Viral Hepatitis Vaccines / Q000008:administration & dosage / Q000191:economics*; D055815:Young Adult
chemical_list: D014761:Viral Hepatitis Vaccines
keywords: Femininity; Hepatitis E; Vaccination strategies