Cost-Effectiveness Analysis of Hepatitis B Immunization in Vietnam: Application of Cost-Effectiveness Affordability Curves in Health Care Decision Making

Tu, H. A. T., de Vries, R., Woerdenbag, H. J., Li, S. C., Le, H. H., van Hulst, M. & Postma, M. J., 1-May-2012, In : Value in Health Regional Issues. 1, 1, p. 7-14 8 p.

Research output: Contribution to journalArticleAcademicpeer-review

Objectives: To perform acost-effectiveness analysis and to identify the coseffectiveness affordability levels for a newborn universal vaccination program against hepatitis B virus (HBV) in Vietnam. Methods: By using a Markov model, we simulated a Vietnamese birth cohort using 1,639,000 newborns in 2002 and estimated the incremental cost-effectiveness ratios for quality-adjusted life-year gained following universal newborn HBV vaccination. Two types of analyses were performed, including and excluding expenditures on the treatment of chronic hepatitis B and its complications. We used Monte Carlo simulations to examine cost-effectiveness acceptability and affordability from the payer's perspective and constructed a cost-effectiveness affordability curve to assess the costs and health effects of the program. Results: In the base-case analysis, newborn universal HBV vaccination reduced the carrier rate by 58% at a cost of US $42 per carrier averted. From the payer's perspective, incremental cost-effectiveness ratio per quality-adjusted life-year gained was US $3.77, much lower than the 2002 per-capita gross domestic product of US $440. Vaccination could potentially be affordable starting at a US $2.1 million budget. At the cost-effectiveness threshold of US $3.77 per quality-adjusted life-year and an annual budget of US $5.9 million, the probability that vaccination will be both cost-effective and affordable was 21%. Conclusions: Universal newborn HBV vaccination is highly cost-effective in Vietnam. In low-income, high-endemic countries, where funds are limited and the economic results are uncertain, our findings on the cost-effectiveness affordability options may assist decision makers in proper health investments. © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR).
Original languageEnglish
Pages (from-to)7-14
Number of pages8
JournalValue in Health Regional Issues
Issue number1
Publication statusPublished - 1-May-2012


  • Acceptability, Affordability, Cost-effectiveness, Incremental cost-effectiveness ratio, Quality-adjusted life-year, hepatitis B vaccine, article, budget, chronic hepatitis, controlled study, cost benefit analysis, cost effectiveness analysis, drug cost, gross national product, hepatitis B, Hepatitis B virus, human, infection control, infection prevention, infection rate, mass immunization, medical decision making, newborn, outcome assessment, priority journal, quality adjusted life year, sensitivity analysis, Viet Nam

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