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Impact of reimbursement program on liver-related mortality in patients with chronic hepatitis B in Beijing, China

Min Li1, Yuan Yuan Kong1, Shan Shan Wu1

  • 1Clinical Epidemiology and Evidence-Based Medicine Unit, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

Journal of Digestive Diseases
|June 25, 2019
PubMed

Insights

Antiviral therapy for chronic hepatitis B (CHB) became reimbursable in Beijing in 2011. This policy significantly reduced liver-related deaths in patients with non-cirrhotic and compensated cirrhotic CHB.

Area of Science:

  • Hepatology
  • Public Health Policy
  • Medical Economics

Background:

  • Antiviral therapy for hepatitis B virus (HBV) infection is crucial for managing chronic hepatitis B (CHB).
  • In Beijing, antiviral therapy reimbursement by medical insurance commenced on July 1, 2011.
  • Assessing the public health impact of this policy on mortality is essential.

Purpose of the Study:

  • To evaluate the effect of the HBV antiviral therapy reimbursement program on liver-related mortality.
  • To analyze the impact on patients with non-cirrhotic and compensated cirrhotic CHB.

Main Methods:

  • Utilized Beijing hospital discharge data (2008-2015) and death certification records (2008-2017).
  • Calculated and compared liver-related mortality rates before and after the policy implementation.
  • Employed Poisson regression to determine the association between the reimbursement program and mortality risk.

Main Results:

  • Included 35,943 CHB patients; 3,832 liver-related deaths observed over 190,695 person-years.
  • Liver-related mortality decreased post-policy: non-cirrhotic CHB (0.38% to 0.16%), compensated cirrhosis (4.03% to 3.39%).
  • The program was linked to reduced mortality risk for both non-cirrhotic (RR 0.40) and compensated cirrhotic CHB (RR 0.84).

Conclusions:

  • Medical insurance coverage for antiviral therapy demonstrably lowered liver-related mortality.
  • The policy benefits patients across different stages of chronic hepatitis B, including those with compensated cirrhosis.
  • This highlights the effectiveness of health insurance policies in mitigating mortality from chronic liver disease.
Abstract

Keywords:
chronic hepatitis Binsurance health reimbursementliver-related death

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