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 bi...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,qualityadjusted 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 percapita 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.展开更多
文摘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,qualityadjusted 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 percapita 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.
