PMID- 28738455
OWN - NLM
STAT- MEDLINE
DCOM- 20190301
LR  - 20190301
IS  - 0254-6450 (Print)
IS  - 0254-6450 (Linking)
VI  - 38
IP  - 7
DP  - 2017 Jul 10
TI  - [Cost-effectiveness and affordability of strategy for preventing mother-to-child 
      transmission of hepatitis B in China].
PG  - 852-859
LID - 10.3760/cma.j.issn.0254-6450.2017.07.003 [doi]
AB  - Objective: To evaluate the cost effectiveness of nationwide prevention of mother 
      to child transmission (PMTCT) strategy for hepatitis B, and estimate the willing 
      to pay and budget impacts on the PMTCT. Methods: The decision analytic Markov 
      model for the PMTCT was constructed and a birth cohort of Chinese infants born in 
      2013 was used to calculate the cost-effectiveness of the PMTCT among them 
      compared with those receiving no intervention. The parameters in the model were 
      obtained from literatures of national surveys or Meta-analysis. The costs, cases 
      of HBV-related diseases and quality-adjusted life-years (QALYs) were obtained 
      from the societal and payer perspectives, respectively. The incremental 
      cost-effectiveness ratio (ICER) was used as measures of strategy optimization. 
      One-way and probability sensitivity analysis were performed to explore the 
      uncertainty of the primary results. In addition, cost-effectiveness acceptability 
      curve and cost-effectiveness affordability curves were drawn to illustrate the 
      cost effectiveness threshold and financial budget of the PMTCT strategy. Results: 
      The lifetime cost for PMTCT strategy was 4 063.5 yuan (RMB) per carrier, which 
      was 37 829.7 yuan (RMB) lower compared with those receiving no intervention. Due 
      to the strategy, a total of 24.516 1 QALYs per person would be gained, which was 
      higher than that in those receiving no intervention. From societal perspective, 
      the ICER was -59 136.6 yuan (RMB) per additional QALYs gained, indicating that 
      the PMTCT is cost effective. The results were reliable indicated by one-way, 
      multi-way and probability sensitivity analyses. By the CEAC, the willing to pay 
      was much lower than the cost-effectiveness threshold. From the affordability 
      curve of the PMTCT strategy, the annual budget ranged from 590.4 million yuan 
      (RMB) to 688.8 million yuan (RMB), which was lower than the financial ability. 
      Based on the results of cost-effectiveness affordability curves, the higher 
      annual budget was determined, the higher probability of affordability for the 
      PMTCT would be obtained under the same willing to pay state. Only when the annual 
      budget reaches 688.8 million yuan (RMB), the goal of PMTCT would be fully 
      realized. Conclusions: The PMTCT strategy in China was cost effective, and the 
      cost is not beyond the financial budget needed and the willing to pay. The 
      strategy, which is consistent with the global hepatitis B elimination efforts, 
      should be conducted widely in China.
FAU - Lin, Y
AU  - Lin Y
AD  - Shenzhen Center for Disease Control and Prevention, Shenzhen 518055, China; 
      Guangdong Pharmaceutical University, Guangzhou 510006, China.
FAU - Zhang, S X
AU  - Zhang SX
AD  - Shenzhen Center for Disease Control and Prevention, Shenzhen 518055, China.
FAU - Yang, P C
AU  - Yang PC
AD  - Shenzhen Center for Disease Control and Prevention, Shenzhen 518055, China; 
      Guangdong Pharmaceutical University, Guangzhou 510006, China.
FAU - Cai, Y L
AU  - Cai YL
AD  - Shenzhen Center for Disease Control and Prevention, Shenzhen 518055, China.
FAU - Zou, Y H
AU  - Zou YH
AD  - Guangdong Pharmaceutical University, Guangzhou 510006, China.
LA  - chi
PT  - Journal Article
PT  - Meta-Analysis
PL  - China
TA  - Zhonghua Liu Xing Bing Xue Za Zhi
JT  - Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi
JID - 8208604
SB  - IM
MH  - Child
MH  - China
MH  - *Cost-Benefit Analysis
MH  - Hepatitis B
MH  - Humans
MH  - Infant
MH  - Infectious Disease Transmission, Vertical/*economics
MH  - Quality-Adjusted Life Years
OTO - NOTNLM
OT  - Affordability
OT  - Cost-effectiveness analysis
OT  - Hepatitis B
OT  - Markov model
OT  - Perinatal transmission
OT  - Vaccination
EDAT- 2017/07/26 06:00
MHDA- 2019/03/02 06:00
CRDT- 2017/07/25 06:00
PHST- 2017/07/25 06:00 [entrez]
PHST- 2017/07/26 06:00 [pubmed]
PHST- 2019/03/02 06:00 [medline]
AID - 10.3760/cma.j.issn.0254-6450.2017.07.003 [doi]
PST - ppublish
SO  - Zhonghua Liu Xing Bing Xue Za Zhi. 2017 Jul 10;38(7):852-859. doi: 
      10.3760/cma.j.issn.0254-6450.2017.07.003.