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Published on: December 15, 2023
Real-World Epidemiology, Clinical and Economic Burden of Chronic Hepatitis B in Japan: A Retrospective Study Using
Takeji Umemura1, Kittima Wattanakamolkul2, Yoshikazu Nakayama2
1Division of Gastroenterology, Department of Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Insights
Chronic hepatitis B (CHB) poses a significant health burden in Japan, with a prevalence of 0.32%. This study highlights the substantial clinical and economic impact of CHB on patients and healthcare systems.
Area of Science:
- Hepatology
- Public Health
- Epidemiology
Background:
- Chronic hepatitis B (CHB) is a major global health concern, particularly in Western Pacific regions.
- Understanding the epidemiology and burden of CHB in Japan is crucial for effective healthcare management.
Purpose of the Study:
- To describe the prevalence, incidence, and treatment patterns of CHB in Japan.
- To evaluate the clinical and economic burden associated with CHB in the Japanese population.
Main Methods:
- Retrospective observational study using the Japan Medical Data Center (JMDC) Claims Database (2010-2019).
- Prevalence cases identified via diagnostic codes and treatment/testing records.
- Newly diagnosed patients defined by specific criteria with at least one year of follow-up data.
Main Results:
- Identified 13,061 prevalent CHB cases (0.32% prevalence).
- Newly diagnosed patients (n=1973) showed progression to cirrhosis (3.4% compensated, 1.5% decompensated) and hepatocellular carcinoma (3.0%) within a median follow-up of 3.1 years.
- Average annual healthcare cost was 870,568 JPY, with higher costs for decompensated cirrhosis and HCC; 43.3% of patients were hospitalized.
Conclusions:
- CHB imposes a significant clinical and economic burden on patients and caregivers in Japan.
- Disease progression and associated complications drive substantial healthcare utilization and costs.
Introduction:
Chronic hepatitis B (CHB) is one of the world's major healthcare problems, especially in the Western Pacific regions. This study describes the prevalence, incidence, treatment profiles and clinical and economic burden of chronic hepatitis B patients in Japan using the Japan Medical Data Center (JMDC) Claims Database.
Methods:
This is a retrospective observational study. Prevalence cases were identified as patients with ≥ 1 inpatient or ≥ 2 outpatient CHB diagnoses and ≥ 2 records for hepatitis B tests or ≥ 1 prescription for CHB treatment between January 2010 and December 2019. Newly diagnosed CHB patients were defined as patients diagnosed from 2010 to 2018 with no history of the disease up to 2 years prior to the diagnosis. The index date is defined as the first CHB diagnosis day. We only used patients' data with ≥ 1-year post-index date.
Results:
We identified 13,061 CHB prevalent cases (2010-2019), yielding a crude period prevalence of 0.32%. Newly diagnosed CHB patients (n = 1973; median age 52 years) were followed for a median period of 3.1 years, during which 15% received a CHB treatment. Entecavir was the most common first treatment (66%). During this period, 3.4% of the patients developed compensated cirrhosis (CC), 1.5% decompensated cirrhosis (DC) and 3.0% hepatocellular carcinoma (HCC). Around 43.3% of CHB patients were hospitalized at least once. Hospitalizations, treatment rates, serologic testing and screening for liver diseases increased as the severity of the disease progressed. The average total healthcare cost was 870,568 JPY (7779 USD) per person per year. DC and HCC resulted in the highest management costs.
Conclusions:
Chronic hepatitis B represents a high clinical and economic burden for patients and caregivers, given its morbidity and associated costs.
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