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Health care costs associated with chronic hepatitis B
M Metcalf1, N Brown, S Peterson
1Glaxo Wellcome Inc., Research Triangle Park, NC 27709-3398, USA. mam44221@glaxo.com
Insights
Patients with chronic hepatitis B (CHB) incur significantly higher healthcare costs compared to those without CHB. These increased costs are evident around diagnosis and persist long-term, impacting overall healthcare expenditure.
Area of Science:
- Hepatology
- Health Economics
- Public Health
Background:
- Chronic hepatitis B (CHB) is a significant global health concern.
- Understanding the economic burden of CHB is crucial for resource allocation and healthcare policy.
- Previous studies have not comprehensively assessed the long-term healthcare costs associated with CHB.
Purpose of the Study:
- To compare the long-term healthcare costs of patients with CHB to those without CHB.
- To identify specific cost categories contributing to the economic burden of CHB.
- To analyze cost differences during prediagnosis, peridiagnosis, and postdiagnosis periods.
Main Methods:
- Retrospective analysis of healthcare costs from an HMO database.
- Matching of 88 CHB patients with 342 control patients without CHB.
- Cost data categorized and analyzed as ratios of CHB patients to control patients over a six-year study period.
Main Results:
- Patients with CHB incurred 3.3 times higher costs during the peridiagnosis period (seven months around the first diagnostic marker).
- Postdiagnosis, CHB patients had 2.9 times higher monthly costs compared to controls.
- Significantly higher peridiagnosis costs were observed in laboratory, radiology, office visits, and pharmacy for CHB patients.
Conclusions:
- CHB is associated with substantially higher healthcare expenditures compared to non-CHB patients.
- The economic burden of CHB is significant both around the time of diagnosis and in the long term.
- Healthcare systems should consider the substantial financial implications of managing chronic hepatitis B.
Abstract:
The long-term health care costs of patients with chronic hepatitis B (CHB) were compared with those of patients without CHB. Patients with laboratory markers for CHB were identified from an HMO database and matched with up to four control patients (either not tested for hepatitis B infection or with negative test results). Cost data were collected retrospectively for both groups of patients for the period up to 30 days before identification of the first marker for hepatitis B (prediagnosis), 30 days before identification of the first marker through 180 days after the identification (peridiagnosis), and 181 days after identification through the end of the six-year study period. Costs were categorized as emergency room, inpatient, short-stay inpatient, laboratory, radiology, office visit, pharmacy, outside claim, or other and were analyzed as ratios of the costs of each patient with CHB to the median of the corresponding control patients. Eighty-eight patients were identified as having CHB; there were 342 control patients. In the seven months surrounding the appearance of their first diagnostic marker, the patients with CHB had costs 3.3 times those of the corresponding control patients and, after the first seven months, 2.9 times those of the control patients per month. Peridiagnosis costs in the categories of laboratory, radiology, office visits, and pharmacy were significantly higher for patients with CHB than for control patients. Except for emergency room costs, postdiagnosis costs per month of the patients with CHB were significantly higher than those of the corresponding control patients. Examination of an HMO database showed that, compared with patients without CHB, patients with CHB had significantly higher health care costs around and after the CHB diagnosis.