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

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Cost-Effectiveness Analysis of Hepatitis B Immunization in Vietnam: Application of Cost- Effectiveness Affordability Curves in Health Care Decision Making Hong Anh T. Tu, PhD, Robin de Vries, PhD, Herman J. Woerdenbag, PhD, Shu Chuen Li, PhD, Hoa H. Le, PhD, Marinus van Hulst, PhD, Maarten J. Postma, PhD Value in Health Regional Issues Volume 1, Issue 1, Pages 7-14 (May 2012) DOI: 10.1016/j.vhri.2012.03.007 Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Terms and Conditions

Fig. 1 Decision analytic model for estimating the cost-effectiveness of universal hepatitis B vaccination in Vietnam. CC, compensated cirrhosis; CHB, chronic hepatitis B; DC, decompensated cirrhosis; HbsAg, hepatitis B surface antigen; HCC, hepatocellular carcinoma. Value in Health Regional Issues 2012 1, 7-14DOI: (10.1016/j.vhri.2012.03.007) Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Terms and Conditions

Fig. 2 Results of univariate sensitivity analyses showing the ranges of ICERs for universal newborn HBV vaccination compared with no vaccination in Vietnam (payer's perspective). HBV, hepatitis B virus; ICERs, incremental cost-effectiveness ratios; QALY, quality-adjusted life-year. Value in Health Regional Issues 2012 1, 7-14DOI: (10.1016/j.vhri.2012.03.007) Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Terms and Conditions

Fig. 3 A total of 5000 Monte Carlo simulations of incremental cost-effectiveness ratios plotted on a cost-effectiveness plane comparing vaccination versus no vaccination. QALY, quality-adjusted life-year. Value in Health Regional Issues 2012 1, 7-14DOI: (10.1016/j.vhri.2012.03.007) Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Terms and Conditions

Fig. 4 Cost-effectiveness (C–E) acceptability curve showing that the probability of universal newborn vaccination against HBV in Vietnam is cost-effective at different cost-effective threshold values (payer's perspective). HBV, hepatitis B virus; QALY, quality-adjusted life-year. Value in Health Regional Issues 2012 1, 7-14DOI: (10.1016/j.vhri.2012.03.007) Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Terms and Conditions

Fig. 5 Affordability curve showing the impact of financial resources on the universal newborn HBV vaccination program in Vietnam (payer's perspective). HBV, hepatitis B virus. Value in Health Regional Issues 2012 1, 7-14DOI: (10.1016/j.vhri.2012.03.007) Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Terms and Conditions

Fig. 6 Cost-effectiveness (C–E) and affordability curve presenting various scenarios for universal newborn HBV vaccination in Vietnam being both cost-effective and affordable at different cost-effective threshold values and budgets (payer's perspective). HBV, hepatitis B virus; QALY, quality-adjusted life-year. Value in Health Regional Issues 2012 1, 7-14DOI: (10.1016/j.vhri.2012.03.007) Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Terms and Conditions