Hepatitis B management costs in France, Italy, Spain and the United Kingdom

Resumo

GOALS: To estimate the costs associated with the management of chronic hepatitis B (CHB) and its sequelae in France, Italy, Spain, and the United Kingdom from the perspective of the healthcare payer. BACKGROUND: The World Health Organization estimates that the disease sequelae related to hepatitis B account for 1 million deaths annually worldwide. Northern Europe is a low endemic area, while Mediterranean regions are classified as intermediate endemic areas. The introduction of vaccination programs in France, Italy, and Spain in recent years has lowered the hepatitis B incidence rates. STUDY: The purpose of this study was to identify the medical management patterns of CHB patients in France, Italy, Spain, and the United Kingdom and estimate the economic burdens of CHB-related disease states for each country. A central questionnaire was used to collect data from specialist physicians in four countries, and responses were collated into management patterns for chronic active hepatitis, compensated and decompensated cirrhosis, and hepatocellular carcinoma. RESULTS: The average cost by disease state for each European country was found to increase across the identified disease states reflecting disease progression. Year-2001 average annual disease state costs per patient were estimated to be as follows: CHB, 1,093 euro-3,396 euro; compensated cirrhosis, 1,134 euro-3,997 euro; decompensated cirrhosis, 5,292 euro-8,842 euro; hepatocellular carcinoma, 3,731 euro-9,352 euro; and, from published sources, liver transplant surgery, 25,165 euro-84,568 euro. CONCLUSION: The cost of CHB is variable both within and between European countries. The association of disease progression with increased cost of disease management suggests that measures to prevent or delay its progression would be economically beneficial.