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These ICERs were below willingness-to-pay levels of China's once GDP per capita (¥59,66, remaining robust in sensitivity analysis. Interpretation Under the intermediate endemic of HBV infection in China, implementation of couple-based immunization strategy can improve the efficiency of preventing MTCT of HBV, and is highly cost-effective. This strategy can be a new immunization strategy choice to achieve the target of eliminating hepatitis B by 2030. Funding National Natural Science Foundation of China. © 2020 Published by