A Cost-effectiveness Analysis Of A Hepatitis B Catch-up Vaccination Program Among The Children Under Certain Age

Objective: Investigate the cost effectiveness of a hepatitis B catch-up vaccinationamong the children under the age of15. Identify the more cost effective strategycomparing with the status quo.Materials and Methods: Data needed in this study is based on the literature study.Costs and effectiveness of Hepatitis B and related diseases are derived from theliteratures published on Pubmed and CNKI between1990and2009. Incidence,chronic rates and mortalities of Hepatitis B and related diseases are derived from thestatistics and literatures published by Ministry of Health of China and Center ofDisease Control between1990and2009. Build Markov model according to theclinical pathway of Hepatitis B and related disease, calculate the health economic databased on Monte-carlo computer simulation. Evaluate the cost effectiveness of thecatch-up vaccination program. Assess the parameters which affect the robustness ofthe model by sensitivity analysis.Results:(1) If implementing the catch-up vaccination, costs of vaccination and thediseases totally accounts232.1billion Yuan, which is1222.8billion Yuan lesscomparing with the status quo.(2) If implementing the catch-up vaccination,effectiveness of vaccination and the diseases totally accounts29million QALYs,which are119million QALYs less comparing with the status quo.(3) Average costeffective ratio of implementing catch-up vaccination equals to7933.1Yuan/QALY,which is less than the status quo.(4) With a higher discount rate on effectiveness, thecost per QALY rises. A higher discount rate urges the policy makers preferring to choose status quo.(5) With a higher protection rate of Hepatitis B vaccination, thecost per QALY drops, and the policy makers tend to choose the catch-up strategy.Conclusion: A hepatitis B catch-up vaccination among the children under the age of15is a cost effective strategy with low cost and high outcomes.