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Impact and Cost-Effectiveness of Biomedical Interventions on Adult Hepatitis B Elimination in China: A Mathematical Modelling Study
BACKGROUND: China has one of the highest hepatitis B virus (HBV) disease burdens worldwide and tracking progress toward the 2030 HBV elimination targets is essential. This study aimed to assess the impact of biomedical interventions (i.e., adult vaccination, screening and treatment) on the adult HBV...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Netherlands
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10469118/ https://www.ncbi.nlm.nih.gov/pubmed/37349664 http://dx.doi.org/10.1007/s44197-023-00132-1 |
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author | Wang, Xinran Du, Zhicheng Wang, Yijing Wang, Junren Huang, Shanshan Wang, Ying Gu, Jing Deng, Wanyu Gilmour, Stuart Li, Jinghua Hao, Yuantao |
author_facet | Wang, Xinran Du, Zhicheng Wang, Yijing Wang, Junren Huang, Shanshan Wang, Ying Gu, Jing Deng, Wanyu Gilmour, Stuart Li, Jinghua Hao, Yuantao |
author_sort | Wang, Xinran |
collection | PubMed |
description | BACKGROUND: China has one of the highest hepatitis B virus (HBV) disease burdens worldwide and tracking progress toward the 2030 HBV elimination targets is essential. This study aimed to assess the impact of biomedical interventions (i.e., adult vaccination, screening and treatment) on the adult HBV epidemic, estimate the time for HBV elimination, and evaluate the cost-effectiveness of the interventions in China. METHODS: A deterministic compartmental model was developed to project the HBV epidemic from 2022 to 2050 and estimate the time to meet elimination targets under four intervention scenarios. Cost-effectiveness was calculated using incremental cost per quality-adjusted life year (QALY) gained, i.e., average cost-effectiveness ratio (CER). RESULTS: Under the status quo, there will be 42.09–45.42 million adults living with HBV in 2050 and 11.04–14.36 million HBV-related deaths cumulatively from 2022 to 2050. Universal vaccination would cumulatively avert 3.44–3.95 million new cases at a cost of US$1027–1261/QALY gained. The comprehensive strategy would cumulatively avert 4.67–5.24 million new chronic cases and 1.39–1.85 million deaths, expediting the realization of the elimination targets forward to 2049. This strategy was also cost-effective with an average CER of US$20,796–26,685/QALY and a saved healthcare cost of US$16.10–26.84 per person. CONCLUSION: China is not on track to meet the elimination targets but comprehensive biomedical interventions can accelerate the realization of the targets. A comprehensive strategy is cost-effective and cost-saving, which should be promoted in primary care infrastructures. Universal adult vaccination may be appropriate in the near future considering practical feasibility. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s44197-023-00132-1. |
format | Online Article Text |
id | pubmed-10469118 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer Netherlands |
record_format | MEDLINE/PubMed |
spelling | pubmed-104691182023-09-01 Impact and Cost-Effectiveness of Biomedical Interventions on Adult Hepatitis B Elimination in China: A Mathematical Modelling Study Wang, Xinran Du, Zhicheng Wang, Yijing Wang, Junren Huang, Shanshan Wang, Ying Gu, Jing Deng, Wanyu Gilmour, Stuart Li, Jinghua Hao, Yuantao J Epidemiol Glob Health Research Article BACKGROUND: China has one of the highest hepatitis B virus (HBV) disease burdens worldwide and tracking progress toward the 2030 HBV elimination targets is essential. This study aimed to assess the impact of biomedical interventions (i.e., adult vaccination, screening and treatment) on the adult HBV epidemic, estimate the time for HBV elimination, and evaluate the cost-effectiveness of the interventions in China. METHODS: A deterministic compartmental model was developed to project the HBV epidemic from 2022 to 2050 and estimate the time to meet elimination targets under four intervention scenarios. Cost-effectiveness was calculated using incremental cost per quality-adjusted life year (QALY) gained, i.e., average cost-effectiveness ratio (CER). RESULTS: Under the status quo, there will be 42.09–45.42 million adults living with HBV in 2050 and 11.04–14.36 million HBV-related deaths cumulatively from 2022 to 2050. Universal vaccination would cumulatively avert 3.44–3.95 million new cases at a cost of US$1027–1261/QALY gained. The comprehensive strategy would cumulatively avert 4.67–5.24 million new chronic cases and 1.39–1.85 million deaths, expediting the realization of the elimination targets forward to 2049. This strategy was also cost-effective with an average CER of US$20,796–26,685/QALY and a saved healthcare cost of US$16.10–26.84 per person. CONCLUSION: China is not on track to meet the elimination targets but comprehensive biomedical interventions can accelerate the realization of the targets. A comprehensive strategy is cost-effective and cost-saving, which should be promoted in primary care infrastructures. Universal adult vaccination may be appropriate in the near future considering practical feasibility. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s44197-023-00132-1. Springer Netherlands 2023-06-22 /pmc/articles/PMC10469118/ /pubmed/37349664 http://dx.doi.org/10.1007/s44197-023-00132-1 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Research Article Wang, Xinran Du, Zhicheng Wang, Yijing Wang, Junren Huang, Shanshan Wang, Ying Gu, Jing Deng, Wanyu Gilmour, Stuart Li, Jinghua Hao, Yuantao Impact and Cost-Effectiveness of Biomedical Interventions on Adult Hepatitis B Elimination in China: A Mathematical Modelling Study |
title | Impact and Cost-Effectiveness of Biomedical Interventions on Adult Hepatitis B Elimination in China: A Mathematical Modelling Study |
title_full | Impact and Cost-Effectiveness of Biomedical Interventions on Adult Hepatitis B Elimination in China: A Mathematical Modelling Study |
title_fullStr | Impact and Cost-Effectiveness of Biomedical Interventions on Adult Hepatitis B Elimination in China: A Mathematical Modelling Study |
title_full_unstemmed | Impact and Cost-Effectiveness of Biomedical Interventions on Adult Hepatitis B Elimination in China: A Mathematical Modelling Study |
title_short | Impact and Cost-Effectiveness of Biomedical Interventions on Adult Hepatitis B Elimination in China: A Mathematical Modelling Study |
title_sort | impact and cost-effectiveness of biomedical interventions on adult hepatitis b elimination in china: a mathematical modelling study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10469118/ https://www.ncbi.nlm.nih.gov/pubmed/37349664 http://dx.doi.org/10.1007/s44197-023-00132-1 |
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