Health economic evaluation of newborn hepatitis B immunization prevention strategies in Ningbo: a Markov modeling study

BackgroundHepatitis B virus (HBV) infection poses a significant public health challenge in China. The Prevention of mother-to-child Transmission (PMTCT) strategy of combining universal hepatitis B vaccination with hepatitis B immunoglobulin (HBIG) for newborns is crucial in preventing widespread inf...

Full description

Saved in:
Bibliographic Details
Main Authors: Wei Feng, Zhengxiong Li, Mingkuan Fan, Sijia Yang, Yuqi Shao, Kui Liu, Shuaishuai Huang, Sanjun Fu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Public Health
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1532604/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850150993491132416
author Wei Feng
Zhengxiong Li
Mingkuan Fan
Sijia Yang
Yuqi Shao
Kui Liu
Shuaishuai Huang
Sanjun Fu
author_facet Wei Feng
Zhengxiong Li
Mingkuan Fan
Sijia Yang
Yuqi Shao
Kui Liu
Shuaishuai Huang
Sanjun Fu
author_sort Wei Feng
collection DOAJ
description BackgroundHepatitis B virus (HBV) infection poses a significant public health challenge in China. The Prevention of mother-to-child Transmission (PMTCT) strategy of combining universal hepatitis B vaccination with hepatitis B immunoglobulin (HBIG) for newborns is crucial in preventing widespread infection. In this study, we conduct health economic evaluation of three strategies: PMTCT, universal vaccination, and non-vaccination for newborns in Ningbo, China.MethodsThis study developed a decision-Markov model and simulated a cohort of 100,000 newborns to assess the cost-effectiveness and cost–benefit of three strategies from a healthcare system perspective. The primary outputs included total costs, life-years (LYs), quality-adjusted life-years (QALYs), incremental cost-effectiveness ratios (ICERs), benefit–cost ratios (BCRs). One-way and probabilistic sensitivity analyses (PSA) were performed to verify the robustness of the model.ResultsAmong the three strategies, the PMTCT results in the least disease burden and mortality related to hepatitis B. In comparison to a cohort of 100,000 unvaccinated infants, the PMTCT is expected to prevent 6,029 cases of acute symptomatic infections, 27,348 HBV carriers, 4,170 chronic infections, 3,597 cases of cirrhosis, 2,911 cases of hepatocellular carcinoma (HCC), and 3,930 HBV-related deaths. The ICERs for PMTCT and universal vaccination were − 56,371.77 yuan/QALY and − 56,654.77 yuan/QALY, respectively. The BCRs for PMTCT and universal vaccination were 19.13 and 15.95, respectively, when compared to no vaccination. The PSA revealed that all ICER scatter points are situated within the fourth quadrant, and the probability of PMTCT being cost-effective exceeds 90%.ConclusionImplementing universal hepatitis B vaccination with HBIG for newborns in Ningbo demonstrated high cost-effectiveness, making the continuation of the PMTCT strategy highly recommended.
format Article
id doaj-art-66fb2e3a15464fdbb965ba344089a9ea
institution OA Journals
issn 2296-2565
language English
publishDate 2025-04-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Public Health
spelling doaj-art-66fb2e3a15464fdbb965ba344089a9ea2025-08-20T02:26:24ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-04-011310.3389/fpubh.2025.15326041532604Health economic evaluation of newborn hepatitis B immunization prevention strategies in Ningbo: a Markov modeling studyWei Feng0Zhengxiong Li1Mingkuan Fan2Sijia Yang3Yuqi Shao4Kui Liu5Shuaishuai Huang6Sanjun Fu7Fenghua District Center for Disease Control and Prevention, Ningbo, ChinaSchool of Medical Informatics and Engineering, Xuzhou Medical University, Xuzhou, ChinaSchool of Medicine, Xiangyang Polytechnic, Xiangyang, ChinaNingbo Municipal Center for Disease Control and Prevention, Ningbo, ChinaFenghua District Center for Disease Control and Prevention, Ningbo, ChinaZhejiang Provincial Center for Disease Control and Prevention, Hangzhou, ChinaNingbo Yinzhou No.2 Hospital, Ningbo, ChinaFenghua District Center for Disease Control and Prevention, Ningbo, ChinaBackgroundHepatitis B virus (HBV) infection poses a significant public health challenge in China. The Prevention of mother-to-child Transmission (PMTCT) strategy of combining universal hepatitis B vaccination with hepatitis B immunoglobulin (HBIG) for newborns is crucial in preventing widespread infection. In this study, we conduct health economic evaluation of three strategies: PMTCT, universal vaccination, and non-vaccination for newborns in Ningbo, China.MethodsThis study developed a decision-Markov model and simulated a cohort of 100,000 newborns to assess the cost-effectiveness and cost–benefit of three strategies from a healthcare system perspective. The primary outputs included total costs, life-years (LYs), quality-adjusted life-years (QALYs), incremental cost-effectiveness ratios (ICERs), benefit–cost ratios (BCRs). One-way and probabilistic sensitivity analyses (PSA) were performed to verify the robustness of the model.ResultsAmong the three strategies, the PMTCT results in the least disease burden and mortality related to hepatitis B. In comparison to a cohort of 100,000 unvaccinated infants, the PMTCT is expected to prevent 6,029 cases of acute symptomatic infections, 27,348 HBV carriers, 4,170 chronic infections, 3,597 cases of cirrhosis, 2,911 cases of hepatocellular carcinoma (HCC), and 3,930 HBV-related deaths. The ICERs for PMTCT and universal vaccination were − 56,371.77 yuan/QALY and − 56,654.77 yuan/QALY, respectively. The BCRs for PMTCT and universal vaccination were 19.13 and 15.95, respectively, when compared to no vaccination. The PSA revealed that all ICER scatter points are situated within the fourth quadrant, and the probability of PMTCT being cost-effective exceeds 90%.ConclusionImplementing universal hepatitis B vaccination with HBIG for newborns in Ningbo demonstrated high cost-effectiveness, making the continuation of the PMTCT strategy highly recommended.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1532604/fullhepatitis Bvaccinationmother-to-child transmissioneconomic evaluationMarkov model
spellingShingle Wei Feng
Zhengxiong Li
Mingkuan Fan
Sijia Yang
Yuqi Shao
Kui Liu
Shuaishuai Huang
Sanjun Fu
Health economic evaluation of newborn hepatitis B immunization prevention strategies in Ningbo: a Markov modeling study
Frontiers in Public Health
hepatitis B
vaccination
mother-to-child transmission
economic evaluation
Markov model
title Health economic evaluation of newborn hepatitis B immunization prevention strategies in Ningbo: a Markov modeling study
title_full Health economic evaluation of newborn hepatitis B immunization prevention strategies in Ningbo: a Markov modeling study
title_fullStr Health economic evaluation of newborn hepatitis B immunization prevention strategies in Ningbo: a Markov modeling study
title_full_unstemmed Health economic evaluation of newborn hepatitis B immunization prevention strategies in Ningbo: a Markov modeling study
title_short Health economic evaluation of newborn hepatitis B immunization prevention strategies in Ningbo: a Markov modeling study
title_sort health economic evaluation of newborn hepatitis b immunization prevention strategies in ningbo a markov modeling study
topic hepatitis B
vaccination
mother-to-child transmission
economic evaluation
Markov model
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1532604/full
work_keys_str_mv AT weifeng healtheconomicevaluationofnewbornhepatitisbimmunizationpreventionstrategiesinningboamarkovmodelingstudy
AT zhengxiongli healtheconomicevaluationofnewbornhepatitisbimmunizationpreventionstrategiesinningboamarkovmodelingstudy
AT mingkuanfan healtheconomicevaluationofnewbornhepatitisbimmunizationpreventionstrategiesinningboamarkovmodelingstudy
AT sijiayang healtheconomicevaluationofnewbornhepatitisbimmunizationpreventionstrategiesinningboamarkovmodelingstudy
AT yuqishao healtheconomicevaluationofnewbornhepatitisbimmunizationpreventionstrategiesinningboamarkovmodelingstudy
AT kuiliu healtheconomicevaluationofnewbornhepatitisbimmunizationpreventionstrategiesinningboamarkovmodelingstudy
AT shuaishuaihuang healtheconomicevaluationofnewbornhepatitisbimmunizationpreventionstrategiesinningboamarkovmodelingstudy
AT sanjunfu healtheconomicevaluationofnewbornhepatitisbimmunizationpreventionstrategiesinningboamarkovmodelingstudy