, Volume 29, Issue 12, pp 1063–1073 | Cite as

Cost-Effectiveness Analysis of Prophylactic Lamivudine Use in Preventing Vertical Transmission of Hepatitis B Virus Infection

  • Hui-Fang Hung
  • Hsiu-Hsi ChenEmail author
Original Research Article Economic Evaluation of Lamivudine Use in Pregnancy


Background: As neonates born to mothers with positive hepatitis B e antigen may not be completely protected by hepatitis B vaccination, prophylactic lamivudine use in mothers with high viraemia has been proposed. However, the overall effectiveness and the balance between cost and benefit for such a prophylactic strategy have rarely been addressed. Objective: Using a review of recent literature, we aimed to assess the cost effectiveness, from the Taiwanese societal perspective, of administering prophylactic lamivudine to mothers to reduce vertical transmission of hepatitis B virus and its long-term sequelae in neonates.

Methods: A meta-analysis of three randomized controlled trials was conducted to evaluate the efficacy of lamivudine versus placebo. A Markov decision model was constructed in which in both treatment arms infants received active and passive immunoprophylaxis. An economic evaluation was performed to calculate costs, acute infections averted, and QALYs gained. Probabilistic sensitivity analyses were conducted and a cost-effectiveness acceptability curve drawn. All these analyses were from the societal perspective. Costs ($US) were valued in year 2008 prices.

Result: Supplemental lamivudine use gained an additional 0.0024 QALYs and averted 0.23 acute infections per birth compared with the routine activepassive immunization without lamivudine. The cost-effectiveness analysis suggested that the use of additional prophylactic lamivudine dominated the routine strategy. The acceptability curve suggested that the probability of being cost effective under the willingness-to-pay threshold of $US20 000 was 94%.

Conclusion: This analysis suggests that supplemental use of lamivudine in mothers with high hepatitis B viraemia is effective in reducing vertical transmission and may be cost effective, from a Taiwanese societal perspective, compared with the routine active-passive immunization without lamivudine.


Lamivudine Vertical Transmission Perinatal Transmission Supplemental Digital Content Lamivudine Group 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Dr Hung and Professor Chen had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. There were no potential conflicts of interest or sources of funding for either author.

Supplementary material

40273_2012_29121063_MOESM1_ESM.pdf (97 kb)
Supplementary material, approximately 99 KB.


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Copyright information

© Springer International Publishing AG 2011

Authors and Affiliations

  1. 1.Hsin-Chu General Hospital, Department of HealthExecutiveYuanTaipeiTaiwan
  2. 2.Division of Biostatistics, Institute of Epidemiology, College of Public HealthNational Taiwan University TaipeiTaipeiTaiwan 100

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