Cost-effectiveness of the controlled temperature chain for the hepatitis B virus birth dose vaccine in various global settings: a modelling study

The Lancet Global Health
Nick ScottMargaret Hellard

Abstract

The controlled temperature chain (CTC) strategy allows vaccines to be kept outside the cold chain for a short period of time. In remote rural areas, the CTC strategy for the hepatitis B virus (HBV) birth dose vaccination could improve its geographical coverage and timeliness of delivery, but with additional outreach costs. We assessed the cost-effectiveness of the CTC strategy for the HBV birth dose across six world regions and 72 countries according to their HBV prevalence, delivery costs, and birth dose coverage and timing. By use of a mathematical model of perinatal HBV transmission and disease progression, we calculated per 1000 births the total HBV-related disability-adjusted life-years (DALYs) and costs, including vaccine delivery costs and costs associated with HBV-related disease, with and without the CTC strategy. A CTC strategy produced health benefits in all regions and was cost-saving in the regions of east Asia and Pacific, Latin America and Caribbean, sub-Saharan Africa, and north Africa and Middle East. The CTC strategy cost US$0·15 (IQR -7·11 to 4·75) per DALY averted in the central and eastern Europe and central Asia region and $79·72 (66·47 to 94·47) in the south Asia region. Within individual countries, more ...Continue Reading

Citations

Nov 8, 2019·Journal of Viral Hepatitis·Shevanthi NayagamMaud Lemoine
Jan 11, 2019·Science Translational Medicine·James G BeesonMichelle J Boyle
Aug 23, 2019·Liver International : Official Journal of the International Association for the Study of the Liver·Sophia E SchröederJessica Howell
Jul 14, 2020·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Ameer AbutalebAbhijit Chowdhury
Sep 25, 2020·Journal of Hepatology·Jessica HowellMargaret Hellard
Nov 2, 2021·Journal of Applied Microbiology·Nathália Alves Araujo de Almeida, Vanessa Salete de Paula

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