Goals: To estimate resource use and expected annual cost of care for subjects with chronic hepatitis B and resulting complications in Canada.
Background: Patients chronically infected with hepatitis B virus are at an increased risk of progressing to complications from deteriorating liver function.
Study: The direct medical costs for six disease states associated with chronic hepatitis B virus infection were estimated for the year 2001.
Methods: Information on resource utilization patterns was obtained from: 1) a questionnaire administered to eight specialists with experience treating hepatitis B patients, and 2) a data set on hospitalizations in nine Canadian provinces for specific diagnostic codes. Unit costs were collected from published literature and provincial physician payment schedules and lists of reimbursed medications. All sources of information were combined to calculate expected annual costs. Uncertainty analysis was performed using Monte Carlo simulations. Costs are reported in 2001 Canadian dollars.
Results: The expected annual per-person costs of care and their 95% confidence intervals (CIs) were: 2191 dollars (CI, 1997 dollars-2556 dollars) for chronic hepatitis B, 2987 dollars (CI, 2389 dollars-4462 dollars) for compensated cirrhosis, 11,228 dollars (CI, 8309 dollars-16,388 dollars) for decompensated cirrhosis, 13,350 dollars (CI, 10,608 dollars-17,187 dollars) for hepatocellular carcinoma, 99,066 dollars (CI, 94,328 dollars-106,833 dollars) for liver transplant, and 38,242 dollars (CI, 33,443 dollars-46,087 dollars) for transplant care after the first year. Main cost drivers were hospitalizations and medications.
Conclusion: The cost of treating Canadian subjects with hepatitis B-related conditions increases substantially with deteriorating liver function. Any new therapy that proves to be more effective at slowing or preventing the course of liver disease progression would be cost-effective.