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Cost-Effectiveness of Risk-Score-Based Surveillance Strategies for Hepatocellular Carcinoma in Patients with Chronic

Ying Chen1, Hao Feng2, Yun Bao1,3,4

  • 1Department of Pharmacy, Shanghai Chest Hospital, Shanghai Jiao Tong University School Of Medicine, Shanghai, China.

Digestive Diseases and Sciences
|September 27, 2025
PubMed

Insights

Risk-based surveillance for hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) patients is cost-effective. Biannual monitoring is recommended for high-risk CHB patients, while low-risk individuals may not require surveillance.

Area of Science:

  • Hepatology
  • Health Economics
  • Public Health

Background:

  • Chronic hepatitis B (CHB) poses a significant risk for hepatocellular carcinoma (HCC) development in China.
  • Low surveillance rates and resource constraints necessitate evaluating cost-effective HCC surveillance strategies for CHB patients.

Purpose of the Study:

  • To evaluate the cost-effectiveness of various risk-based HCC surveillance strategies for CHB patients in China.
  • To compare different surveillance frequencies against no surveillance, considering China's willingness-to-pay threshold.

Main Methods:

  • A state-transition model simulated CHB patient disease progression over lifetimes.
  • Patients were stratified into low, intermediate, and high-risk categories based on HCC risk scores.
  • Cost-effectiveness was assessed using life expectancy, QALYs, total costs, and ICERs.

Main Results:

  • Biannual and annual surveillance were cost-effective for overall and intermediate-risk CHB cohorts.
  • For high-risk CHB patients, most surveillance strategies (except quinquennial) were cost-effective.
  • No surveillance strategy proved cost-effective for the low-risk CHB group.

Conclusions:

  • HCC surveillance cost-effectiveness in CHB patients is risk-dependent.
  • A risk-stratified approach, prioritizing biannual surveillance for high-risk patients and potentially omitting it for low-risk patients, optimizes resource allocation.
Abstract

Keywords:
Chronic hepatitis BCost-effectivenessHepatocellular carcinomaRisk scoreSurveillance

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