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Impact of a new reimbursement program on hepatitis B antiviral medication cost and utilization in Beijing, China

Qian Qiu1, Yan Li2, Xiao-wan Duan2

  • 1Dept of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China.

Plos One
|October 21, 2014
PubMed

Insights

A new partial reimbursement policy for Hepatitis B virus (HBV) infection in Beijing increased antiviral utilization and medical costs for insured patients. The policy may optimize antiviral treatment costs and standardization for chronic hepatitis B (CHB) patients.

Area of Science:

  • Hepatology
  • Health Economics
  • Public Health Policy

Background:

  • Hepatitis B virus (HBV) infection poses a significant clinical and financial burden on patients with chronic hepatitis B (CHB).
  • Beijing implemented a partial reimbursement policy for antiviral agents for CHB patients on July 1, 2011.
  • Understanding the policy's impact on medical costs and antiviral utilization is crucial.

Purpose of the Study:

  • To describe medical costs and antiviral therapy utilization rates among CHB patients.
  • To explore the impact of the new partial reimbursement policy on medical care costs and antiviral utilization.
  • To analyze changes in the composition of medical care and antiviral usage post-policy implementation.

Main Methods:

  • Retrospective cohort study analyzing clinical and claims data from 92,776 outpatients and 2,774 inpatients with non-cirrhotic CHB.
  • Data collected from You'an Hospital, Beijing, between February 14, 2008, and December 31, 2012.
  • Propensity score matching used to adjust for factors influencing total annual cost (age, gender, insurance type, treatment indicator).

Main Results:

  • Medical costs, particularly antiviral expenses, increased more significantly for insured patients compared to out-of-pocket payers after the policy's start date.
  • Antiviral utilization rose by 16% among insured outpatients.
  • Antiviral usage increased by 3% among out-of-pocket paying patients post-policy implementation.

Conclusions:

  • Direct medical costs and antiviral utilization rates were higher for CHB patients with medical insurance than for those paying out-of-pocket, even after adjustments.
  • The new partial reimbursement program shows potential to positively optimize the cost and standardization of antiviral treatment for CHB.
  • Policy evaluation is essential for improving healthcare management of chronic diseases.
Abstract

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