Cost-effectiveness of hepatitis A vaccination for adults in China: A decision tree Markov model study

This peer-reviewed journal article presents a cost-effectiveness analysis of hepatitis A vaccination strategies for adults aged 20 years and older in China. The study uses a decision tree Markov model to compare multiple vaccination approaches—such as serological screening followed by vaccination of susceptible individuals, and vaccination without prior screening—against a no-vaccination scenario. The analysis adopts a societal perspective and incorporates epidemiological and cost data from previously published sources to estimate health and economic outcomes.

Key findings and insights:

• All evaluated hepatitis A vaccination strategies for adults were cost-saving compared to no vaccination, increasing QALYs while reducing overall costs.
• In a cohort of 100,000 adults aged 20–78 years, vaccination strategies prevented approximately 4,024–4,180 hepatitis A cases.
• Vaccination strategies generated incremental savings of $1,584–$2,733 per QALY gained at a willingness-to-pay threshold of one times China’s per capita GDP.
• Pre-vaccination serological screening improved cost-effectiveness by targeting vaccination to susceptible individuals and avoiding unnecessary vaccination.
• Screening followed by a single dose of live attenuated hepatitis A vaccine (HepA-L) was identified as the most cost-effective strategy among all options.
• Strategies without prior screening were dominated (less efficient and more costly) compared to screening-based approaches.
• Results were robust across both deterministic and probabilistic sensitivity analyses.