COST-EFFECTIVENESS OF ANTIVIRAL PROPHYLAXIS DURING PREGNANCY TO PREVENT PERINATAL HEPATITIS B INFECTION IN SOUTH KOREA

OBJECTIVES: To analyze the cost-effectiveness of the nationwide Perinatal Hepatitis B Prevention Program (PHBPP) and identify the optimal strategy of eliminating mother-to-child transmission of hepatitis B virus (HBV) in Korea. METHODS: A decision tree model with a Markov process was developed and s...

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Bibliographic Details
Published in:Value in health 2017-05, Vol.20 (5), p.A76
Main Authors: Lee, D, Park, SM, Shin, HY
Format: Article
Language:English
Subjects:
Antiviral drugs
Childbirth & labor
Clinical outcomes
Cost analysis
Health care expenditures
Health status
Help seeking behavior
Hepatitis
Hepatitis B
Immunization
Infections
National health insurance
Perinatal
Pregnancy
Prevention programs
Prophylaxis
Quality adjusted life years
Vaccination
Willingness to pay
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Summary:OBJECTIVES: To analyze the cost-effectiveness of the nationwide Perinatal Hepatitis B Prevention Program (PHBPP) and identify the optimal strategy of eliminating mother-to-child transmission of hepatitis B virus (HBV) in Korea. METHODS: A decision tree model with a Markov process was developed and simulated over the lifetime of the 2014 birth cohort in Korea. The current PHBPP was compared against two other strategies, universal hepatitis B vaccination and the PHBPP with antiviral prophylaxis, by their costs and health outcomes. The Korean National Health Insurance (NHI) database was investigated to estimate the costs of HBV-related diseases and utilization of health resources. Costs were assessed from the health care system perspective. Health outcome measures were Quality-adjusted Life Years (QALYs), and the number of HBV-related diseases and deaths. The Incremental Cost-Effectiveness Ratio (ICER) produced from the analysis was evaluated by the amount of Willingness-to-Pay (WTP) in the Korean society. RESULTS: The nationwide PHBPP in Korea is cost-saving compared to the universal hepatitis B vaccination. An introduction of antiviral prophylaxis to pregnant women with a high viral load of HBV saved 55 QALYs (ICER: $19,163 per QALY) and averted 13 HBV-related deaths per 100,000 people compared to the current PHBPP. CONCLUSIONS: Considering that the WTP of Korea is $30,000, the strategy of PHBPP with antiviral prophylaxis is cost-effective. To further decrease the burden of perinatal hepatitis B in Korea, adding antiviral prophylaxis to the current PHBPP is recommended.
ISSN:1098-3015
1524-4733
DOI:10.1016/j.jval.2017.05.005