Objective  To estimate long-term cost-effectiveness of hepatitis B vaccine (HBV) immunization among people born between 1992 and 2013 in Beijing and to provide evidences for policy making and optimizing immunization strategies.

  Methods  Cost-effectiveness and incremental cost-effectiveness ratio were adopted in the study. The cost of HBV immunization was that paid by institutions implementing the immunization and incidence of chronic hepatitis B (CHB) among population in Beijing city was used as effectiveness indicator.

  Results  During the period from 1992 to 2003 in the population of Beijing, the total decreased number of CHB incidents attributed to the HBV immunization was 4 403 and the total cost of the HBV immunization was 134 194 200 yuan; the average cost for one prevented CHB case was 30 477.90 yuan. The cost-effectiveness ratio of HBV immunization showed a steady upward trend during the period, with the lowest value of 16.79 in 2006 and the highest of 168.39 in 2013. In terms of incremental cost effect ratio, during 1999 – 2005, the total cost of HBV immunization would increase by 195 000 yuan for every 1/100 000 increase in CHB incidence compared with that during 1992 – 1998; while, during 2006 – 2013, the total cost of HBV immunization would increase by 2 277 500 yuan for every 1/100 000 increase in CHB incidence compared with that during 1999 – 2005.

  Conclusion  The HBV immunization implemented in Beijing during 1998 – 2013 was of cost-effectiveness．However, the cost-effectiveness of HBV immunization does not reach a optimal level, suggesting that the performance of HBV immunization needs to be improved.