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Abstract
Purpose: To assess the economic aspects of HBV (hepatitis B virus) transmission prevention for premarriage individuals in a country with cultural backgrounds like Iran and intermediate endemicity of HBV infection. Methods: A cost-effectiveness analysis model was used from the health care system and society perspectives. The effectiveness was defined as the number of chronic HBV infections averted owing to one of the following strategies: HBsAg screening to find those would-be couples one of whom is HB-sAg positive and putting seronegative subjects on a protection protocol comprising HBV vaccination, single dose HBIG and condom protection. HBsAg screening as above, in addition to performing HBcAb screening in the HBsAg negative spouses of the HBsAg positive persons and giving the protocol only to HBcAb negative ones. Sensitivity and threshold analyses were conducted. Results: The cost of each chronic infection averted was 202$ and 197$ for the strategies 1 and 2, respectively. Sensitivity analysis showed that strategy 2 was always slightly cheaper than strategy 1. The threshold value for the lifetime costs of chronic liver disease below which the model was cost saving was 1346$ in strategy 1 and 1312$ in strategy 2. Conclusions: Premarriage prevention of HBV transmission in the countries with cultural backgrounds similar to Iran seems cost saving.
Highlights
MethodsA cost-effectiveness analysis model was used from the health care system and society perspectives
To assess the economic aspects of HBV transmission prevention for premarriage individuals in a country with cultural backgrounds like Iran and intermediate endemicity of HBV infection
Though premarriage prevention of HBV transmission in the countries with cultural backgrounds similar to Iran seems cost saving, further studies determining precise costs of HBV infection in Iran can lead to a better analysis
Summary
A cost-effectiveness analysis model was used from the health care system and society perspectives. The effectiveness was defined as the number of chronic HBV infections averted owing to one of the following strategies: 1) HBsAg screening to find those would-be couples one of whom is HBsAg positive and putting seronegative subjects on a protection protocol comprising HBV vaccination, single dose HBIG and condom protection. 2) HBsAg screening as above, in addition to performing HBcAb screening in the HBsAg negative spouses of the HBsAg positive persons and giving the protocol only to HBcAb negative ones. Screening all premarriage individuals for HBsAg and performing the following prevention protocol (marked as P.P. in Fig. 1) for HBsAg negative individuals whose would-be spouse is HBsAg positive: a. An extra dose vaccine and additional condom protection for another month for the persons whose HBsAb is not in protective ranges (lower than 10 IU/l)
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