Department of Epidemiology and Biostatistics, School of Health, Gonabad University of Medical Sciences, Gonabad, Iran.
Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
Hum Vaccin Immunother. 2021 Jun 3;17(6):1825-1833. doi: 10.1080/21645515.2020.1845522. Epub 2021 Mar 18.
Vaccination is an essential way to prevent the transmission of hepatitis B virus (HBV). Various studies have been published on the cost-effectiveness of HBV vaccination, but since the results vary according to the target population and related health outcomes, this study examined the cost-effectiveness of the universal HBV vaccination in Iran. In this economic evaluation study, a decision tree with the Markov model was used to compare the universal HBV vaccination with a strategy of non-vaccination. Health states used in the model included healthy, chronic hepatitis B, compensated cirrhosis, decompensated cirrhosis, hepatocellular carcinoma, and death. Analyses were performed from a payer's perspective. Incremental cost-effectiveness ratio (ICER) per life-year gained, and quality-adjusted life-years (QALYs) gained were calculated at a 5% annual discount rate. The sensitivity analysis was conducted using Monte Carlo simulation. Analyses were performed using Microsoft Excel and TreeAge Pro 2011 software. In 2017, the estimated cost per dose for any HBV vaccine was $3.20 USD. The universal HBV vaccination was economically advantageous compared to non-vaccination, and the estimated cost of this program per life-year and QALY gained were $6,319 and negative (-) $1,183.85 USD, respectively. Given the uncertainty of all parameters, the model remained robust and reliable. In Iran, the universal HBV vaccination strategy for both health outcomes of QALY and life-years gained was cost-effective and advantageous. The vaccination strategy saved money, increased life years and improved quality of life. Therefore, it is recommended that this program continues to be provided.
接种疫苗是预防乙型肝炎病毒（HBV）传播的重要手段。已有多项研究发表了 HBV 疫苗接种的成本效益，但是由于结果因目标人群和相关健康结果而异，因此本研究考察了伊朗全民 HBV 疫苗接种的成本效益。在这项经济评估研究中，使用决策树和马尔可夫模型来比较全民 HBV 疫苗接种和非接种策略。模型中使用的健康状况包括健康、慢性乙型肝炎、代偿性肝硬化、失代偿性肝硬化、肝细胞癌和死亡。分析从支付者的角度进行。每获得一个生命年的增量成本效益比（ICER）和获得的质量调整生命年（QALYs）在 5%的年度贴现率下计算。使用蒙特卡罗模拟进行敏感性分析。使用 Microsoft Excel 和 TreeAge Pro 2011 软件进行分析。2017 年，任何 HBV 疫苗的估计单价为 3.20 美元。与不接种疫苗相比，全民 HBV 疫苗接种具有经济优势，该计划每获得一个生命年和 QALY 的估计成本分别为 6319 美元和负（-）1183.85 美元。考虑到所有参数的不确定性，模型仍然稳健可靠。在伊朗，全民 HBV 疫苗接种策略在 QALY 和生命年获得方面均具有成本效益和优势。接种策略节省了资金，增加了生命年并提高了生活质量。因此，建议继续提供该计划。
