ArticleEClinicalMedicine2020
Cost-effectiveness of couple-based immunization strategy to prevent mother-to-child transmission of hepatitis B virus in China: A decision-analytic Markov model.
Article in EClinicalMedicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Economic evaluation of hepatitis B screening in low- and middle-income countries: a systematic review.International journal of clinical pharmacy · 2025Pooled it
- Hepatitis B and D burden in Uzbekistan: comprehensive analysis of seroprevalence and risk correlates from a countrywide study.Infectious diseases of poverty · 2026Article
- Global, regional, and national burdens of liver disease due to hepatitis B in women of childbearing age, 1990 to 2021: an analysis of the Global Burden of Disease Study.AJOG global reports · 2026Article
- Progress toward elimination mother-to-child transmission of HBV in Shandong Province, China: Coverage trend in hepatitis B vaccination and HBIG administration, 2017-2024.Human vaccines & immunotherapeutics · 2025Article
- Curative care expenditure across different comorbidity states of chronic hepatitis B: a prevalence study in Sichuan Province, China.BMJ open · 2025Article
- Health economic evaluation of newborn hepatitis B immunization prevention strategies in Ningbo: a Markov modeling study.Frontiers in public health · 2025Article
- Assessing the impact of comorbid type 2 diabetes mellitus on the disease burden of chronic hepatitis B virus infection and its complications in China from 2006 to 2030: a modeling study.Global health research and policy · 2024Article
- Article
- Viral hepatitis and pregnancy.Nature reviews. Gastroenterology & hepatology · 2021Review
- Ethnic Disparities in Hepatitis B Virus Infection Among 1 Million Reproductive-Age Couples Preparing for Pregnancy in the Rural Yunnan, China: A Population-Based Cross-Sectional Study.Frontiers in medicine · 2021Article
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5 authors at 1 institution in 1 country.
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Abstract
backgroundMother-to-child transmission (MTCT) is the major route of HBV transmission in many parts of the world. We designed couple-based immunization strategy and aimed to assess the cost-effectiveness of this strategy in China.
methodsWe constructed a decision-analytic Markov model to compared current immunization strategy consisting of hepatitis B vaccination (HepB) for all infants and extra hepatitis B immunoglobulin for infants with HBsAg-positive mothers versus couple-based immunization strategy including additional HBV screening for pre-pregnant couples and HepB for high-risk wives. Costs were assessed from a healthcare system perspective. Number of infants with perinatal HBV infection, life-years (LYs), quality-adjusted life-years (QALYs), and disability-adjusted life-years (DALYs) were used to access effects. We calculated incremental cost-effectiveness ratios (ICERs) and performed sensitivity analysis.
findingsBased on the birth cohort of 17,578,815 livebirths in China in 2017, couple-based immunization strategy reduced perinatal HBV infection by 18% (9194/51,365) with cost increase of ¥ 41 million, saved 49,986 LYs (ICER: ¥819 per LY saved), gained 48,879 QALYs (ICER: ¥837 per QALY gained) and averted 63,362 DALYs (¥646 per DALY averted) compared with current immunization strategy. These ICERs were below willingness-to-pay levels of China's once GDP per capita (¥59,660), remaining robust in sensitivity analysis.
interpretationUnder the intermediate endemic of HBV infection in China, implementation of couple-based immunization strategy can improve the efficiency of preventing MTCT of HBV, and is highly cost-effective. This strategy can be a new immunization strategy choice to achieve the target of eliminating hepatitis B by 2030.
fundingNational Natural Science Foundation of China.
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