Analytical approach:
The analysis was based on a decision tree, followed by a Markov model, with one-year cycles until 80 years. The authors stated that the analysis was carried out from a societal perspective.
Effectiveness data:
The clinical effectiveness estimates were primarily from a systematic literature search and meta-analysis, conducted by the authors, which identified and analysed three randomised controlled trials (RCTs) that compared lamivudine versus placebo. The other transition probabilities for the model were from the literature. The main clinical estimate was the relative risk of mother-to-child transmission with versus without lamivudine.
Monetary benefit and utility valuations:
The utility values were identified from the literature by a previous cost-effectiveness study on the prevention of hepatitis B in Asian and Pacific Island adults.
Measure of benefit:
The summary benefit measures were quality-adjusted life-years (QALYs) and the number of hepatitis B infections averted.
Cost data:
The economic analysis included the costs of vaccination, laboratory testing, drugs, disease treatment, and productivity losses due to early death. The costs were presented as category totals, and were from several sources, including the Bureau of National Health Insurance of Taiwan and published studies. All costs were reported in US $ and the price year was 2008. Costs were discounted at an annual rate of 3%.
Analysis of uncertainty:
Probabilistic sensitivity analysis, with Monte Carlo simulation, was conducted to assess the impact of the overall parameter uncertainty. Beta, gamma, and triangular distributions were used for the clinical inputs and triangular distributions were used for the cost inputs. The results were presented in a scatter plot and a cost-effectiveness acceptability curve.