Cost-Effectiveness Analysis of Sequential Screening Strategies for Hepatitis B Virus Infection by Birth Cohort - China.

IF 4.3 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

中国疾病预防控制中心周报 Pub Date : 2025-04-25 DOI:10.46234/ccdcw2025.096

Lei Wang, Hui Zheng, Lanfang Xia, Guomin Zhang, Fuzhen Wang, Zundong Yin, Huaqing Wang

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Abstract

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.

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出生队列乙型肝炎病毒感染序贯筛查策略的成本-效果分析

消除作为主要公共卫生威胁的乙型肝炎病毒（HBV）是全球卫生优先事项，需要具有成本效益的筛查策略。本研究评估了中国顺序出生队列HBV筛查策略的成本-效果。方法：使用马尔可夫模型，我们将五种筛查策略与目前的做法进行比较，计算hbv相关的避免死亡、获得的质量调整生命年（QALYs）和增量成本-效果比（ICER）。进行了单向确定性和概率敏感性分析，以评估结果的稳健性。结果：顺序出生队列筛查策略（顺序筛查1：在2025-2026年筛查1991-2000年队列，在2027-2028年筛查1971-1990年队列，在2029-2030年筛查1951-1970年队列）是最具成本效益的，ICER为58,523元/ QALY，支付意愿阈值为人均国内生产总值（GDP）的3倍。另一种策略是在2025-2026年优先考虑1951-1970年队列，避免了大多数hbv相关死亡（约344万），并获得了2490万QALY， ICER为60113元/ QALY，也显示出成本效益。讨论：我们的研究结果支持序贯出生队列筛查作为实现世卫组织消除HBV目标的最佳和创新方法，为决策者优化筛查计划和资源分配提供循证指导。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

中国疾病预防控制中心周报

CiteScore

5.90

自引率

0.00%

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