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Published on: February 1, 2017
Cost-Effectiveness Analysis of Sequential Screening Strategies for Hepatitis B Virus Infection by Birth Cohort -
Lei Wang1, Hui Zheng1, Lanfang Xia1
1National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China.
Introduction:
Eliminating hepatitis B virus (HBV) as a major public health threat is a global health priority that requires cost-effective screening strategies. This study evaluated the cost-effectiveness of sequential birth cohort HBV screening strategies in China.
Methods:
Using a Markov model, we compared five screening strategies with current practice, calculating HBV-related deaths averted, quality-adjusted life years (QALYs) gained, and incremental cost-effectiveness ratios (ICER). One-way deterministic and probabilistic sensitivity analyses were conducted to evaluate the robustness of the results.
Results:
The sequential birth cohort screening strategy (Sequential Screening 1: screening the 1991-2000 cohort in 2025-2026, the 1971-1990 cohort in 2027-2028, and the 1951-1970 cohort in 2029-2030) was the most cost-effective, with an ICER of 58,523 Chinese Yuan (CNY) per QALY at a willingness-to-pay threshold of three times the per-capita Gross Domestic Product (GDP). An alternative strategy that prioritized the 1951-1970 cohort in 2025-2026 averted the most HBV-related deaths (approximately 3.44 million) and gained 24.9 million QALYs, with an ICER of 60,113 CNY per QALY, also showing cost-effectiveness.
Discussion:
Our findings support sequential birth cohort screening as an optimal and innovative approach to achieving the WHO HBV elimination targets, offering evidence-informed guidance for policymakers to optimize screening programs and resource allocation.
