A new study in Vaccines evaluated the cost-effectiveness of hepatitis E vaccination strategies in patients with chronic liver diseases in China. Researchers used a decision tree–Markov cohort model to assess the cost-effectiveness of universal-vaccination, vaccination-following-screening, and no-vaccination strategies in 100,000 chronic liver disease patients over their lifetimes, simulating cohorts aged ≥16 years, ≥40 years, and ≥60 years, based on the licensed vaccination ages and typical ages of disease onset, from a societal perspective.
The findings showed that compared to no-vaccination, universal-vaccination reduced hepatitis E virus-related cases by 33% to 40%, while vaccination-following-screening reduced them by 38% to 49%. Furthermore, universal-vaccination showed incremental cost-effectiveness ratios (ICERs) of USD US$6898, US$6639, and US$6583 per quality-adjusted life year (QALY) for cohorts aged ≥16, ≥40, and ≥60 years, respectively. Moreover, the vaccination-following-screening strategy significantly enhanced cost-effectiveness, with ICERs decreasing to $6202, US$5199 and US$4920 per QALY for the cohorts.
Hepatitis E vaccination in chronic liver disease patients costs less than GDP per capita for each QALY gained in China. The vaccination-following-screening strategy may be the optimal option, especially in those over 60 years.
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