Cost Effective To Track Hepatitis B Carriers

A study has determined that monitoring inactive chronic hepatitis B carriers is a cost-effective strategy for managing the disease in China.

Asian Scientist (Jan. 24, 2014) – A study has determined that monitoring inactive chronic hepatitis B (HBV) carriers is a cost-effective strategy for managing the disease in China.

However, the results published in Hepatology also show that increasing treatment, monitoring and adherence to therapy are necessary to achieve significant health benefits at the population level.

The World Health Organization (WHO) estimates that roughly 2 billion individuals worldwide have been infected with HBV—a virus causing acute or chronic liver disease that may lead to cirrhosis or liver cancer (hepatocellular carcinoma, HCC).

Previous research had shown that 60% of the population in China has been infected with HBV and up to 10% are chronically infected, placing them at risk for life-threatening liver disease. It is estimated that 500,000 Chinese die each year from HBV-related causes.

“China has the largest concentration of people infected with chronic HBV and understanding the health and economic impact is extremely important,” explains Dr. Mehlika Toy who spearheaded the study.

“Our study is the first to analyze cost and cost-effectiveness of monitoring inactive chronic hepatitis B patients in Shanghai.”

Using simulation models, the research team compared the current strategy of not monitoring inactive chronic HBV patients to a monitor and treat (M&T) strategy. The M&T strategy would include twice-yearly assessment of HBV and alanine transaminase (ALT) levels in patients with chronic HBV. For active HBV cases the researchers suggest treatment with entecavir, which evidence shows to be a cost-effective antiviral therapy in China.

The researchers estimated that the M&T strategy would cost US$20,730 and result in 15.45 quality-adjusted life-years (QALY) per patient, compared to US$20,455 and 15.35 QALYs for the current practice.

“Our findings suggest that monitoring of chronic HBV patients is cost-effective, but relies on identifying more cases of HBV infection, and increasing treatment, monitoring, and antiviral adherence to achieve health gains,” concludes Dr. Toy.

“We estimate that with adherence to monitoring and treatment, HCC could be reduced by 70% and mortality caused by chronic HBV by 83%.”

The article can be found at: Toy M et al. (2014) Population Health Impact and Cost-Effectiveness of Monitoring Inactive Chronic Hepatitis B And Treating Eligible Patients In Shanghai, China.

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Source: Wiley; Photo: MojoBaron/Flickr/CC.
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