Aggarwal, Rakesh ; Ghoshal, Uday C. ; Naik, Subhash R. (2003) Assessment of cost-effectiveness of universal hepatitis B immunization in a low-income country with intermediate endemicity using a Markov model Journal of Hepatology, 38 (2). pp. 215-222. ISSN 0168-8278
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Official URL: http://www.sciencedirect.com/science/article/pii/S...
Related URL: http://dx.doi.org/10.1016/S0168-8278(02)00382-3
Abstract
Background/Aims: Most countries with high hepatitis B (HB) virus endemicity and most high-income countries have introduced immunization programmes against this infection. However, several low-income countries with intermediate HB endemicity have not done so. We performed a cost-effectiveness analysis of universal childhood HB immunization in such countries using India as an example, since available data on this aspect are limited. Methods: Marginal cost of every life-year and quality-adjusted life-year (QALY) gained with universal HB vaccination was calculated using a Markov model. Two types of analyses (including and excluding expenditure on treatment of long-term complications of HB infection) were done. Several sensitivity analyses and Monte-Carlo simulation were performed. Results: Universal immunization reduced the HB carrier rate by 71%, and increased the number of years and QALY lived by a birth-cohort by 0.173 years (61.072 vs. 60.899 years) and 0.213 years (61.056 vs. 60.843 years), respectively. Marginal costs were US$16.27 per life-year gained and US$13.22 per QALY gained, much lower than annual per capita income. One-way sensitivity analysis and Monte-Carlo simulation confirmed the robustness of the conclusions. Conclusions: Universal HB immunization is highly cost-effective in low-income countries with intermediate endemicity rates.
Item Type: | Article |
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Source: | Copyright of this article belongs to Elsevier Science. |
Keywords: | Cost-benefit Analysis; Cost-utility Analysis; Economic Analysis; Hepatitis B Virus; Prevention; Monte-Carlo Simulation |
ID Code: | 94611 |
Deposited On: | 19 Oct 2012 04:40 |
Last Modified: | 19 Oct 2012 04:40 |
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