Economic burden and healthcare resource utilization

“Using Commercial, Medicare, and Medicaid databases from 2004 to 2015 and ICD9 codes, we retrospectively identified adults with CHB, analyzing all-cause inpatient, outpatient, and pharmaceutical utilization and costs by disease severity.” (opens the source at this quote in a new tab)CopyFlag

“Our sample consisted of 33,904 CHB cases and 86,072 non-CHB controls.” (opens the source at this quote in a new tab)CopyFlag

“Total mean all-cause annual healthcare costs were highest in patients with decompensated cirrhosis, HCC or receiving liver transplant compared to patients with CLD across insurance types (all p <0.05 except Medicare HCC) (Fig. 1), (e.g., for Commercial: $142,870, $124,123 and $171,851 vs. $18,619, respectively).” (opens the source at this quote in a new tab)CopyFlag

“Specifically, for the non-cirrhotic or compensated cirrhotic patients their costs ranged from $1,393 to $2,609 (dependent on payer group) compared to $30,849 to $130,139 for those with a history of liver transplant and again dependent on payer group (all p <0.05) (Fig. 3).” (opens the source at this quote in a new tab)CopyFlag

“However, even patients with CLD had three times the annual healthcare cost of matched non-CHB controls across payers (all p <0.05) (Fig. 4).” (opens the source at this quote in a new tab)CopyFlag

“Compensated liver disease: 98% non-cirrhotic CHB; 2% compensated cirrhosis.” (opens the source at this quote in a new tab)CopyFlag

“The largest all-cause cost components for Commercial and Medicaid were inpatient costs for all advanced liver disease groups (Commercial: 62%, 47%, 68%; Medicaid: 81%, 72%, 74%, respectively), and decompensated cirrhosis and hepatocellular carcinoma groups for Medicare (Medicare 49% and 48%).” (opens the source at this quote in a new tab)CopyFlag

“Average inpatient length of stay was also highest in decompensated cirrhosis and liver transplantation (Commercial 8.3 and 10.8 days, Medicaid 9.3 and 7.4 days, Medicare 7.3 and 5.8 days, respectively) (Table 3).” (opens the source at this quote in a new tab)CopyFlag

“Across all payers, patients with decompensated cirrhosis had the highest emergency department utilization (1.6–2.8 annual visits) and highest mean annual costs.” (opens the source at this quote in a new tab)CopyFlag

“The 2016–2019 National Inpatient Sample was used to select individuals diagnosed with CHB.” (opens the original PMC page at this quote in a new tab)View highlighted excerpt for this quoteCopyFlag

“From 2016 to 2019, the total costs of hospitalizations in CHB patients were $603.82, $737.92, $758.29, and $809.01 million dollars from 2016 to 2019, respectively.” (opens the original PMC page at this quote in a new tab)View highlighted excerpt for this quoteCopyFlag

“We did not observe significant cost trends in the composite CHB population or in the cirrhosis and non-cirrhosis cohorts.” (opens the original PMC page at this quote in a new tab)View highlighted excerpt for this quoteCopyFlag

“Study cohort included 18,603 Medicare recipients with CH-B. Between 2005 and 2014, number of Medicare beneficiaries with CH-B increased by 4.4% annually.” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quoteCopyFlag

“Furthermore, 7.4% of CH-B Medicare cohort experienced decompensated cirrhosis, 2.9% hepatocellular carcinoma (HCC) and 11.9% 1-year mortality.” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quoteCopyFlag

“Annual total inpatient charges increased from $66,610 to $94,221 while these charges for outpatient increased from $9257 to $47,863.” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quoteCopyFlag

“Among patients treated with NAs ( N = 2368), 1428 (60%) were CHB mono-infected and 748 (32%) were HIV co-infected. Total costs per patient per year (PPPY) were $39,240, $29,957, and $55,220 PPPY for NA-treated, mono-infected, and HIV co-infected patients, respectively.” (opens the original PMC page at this quote in a new tab)View highlighted excerpt for this quoteCopyFlag

“Persistence among the inception cohort was 29% for first year and 14% for first 2 years.” (opens the original PMC page at this quote in a new tab)View highlighted excerpt for this quoteCopyFlag

“Over the study period, 1.9 billion USD was spent on NA, with spending peaking in 2016 at $289 million US, which has subsequently decreased. Lower expenditures since 2016 have been associated with increased use of generics. The use of generic tenofovir or entecavir led to savings of $669 million US over the study period.” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quoteCopyFlag

“The prices listed below are Average Wholesale Prices” (opens the source at this quote in a new tab)CopyFlag

“The price paid by consumers may be higher or lower than the prices listed below.” (opens the source at this quote in a new tab)CopyFlag

“Wholesale Acquisition Cost (WAC) plus 20%” (opens the source at this quote in a new tab)CopyFlag

“Source: First Databank, 01/28/2024.” (opens the source at this quote in a new tab)CopyFlag

“Although the lowest price for antiviral drugs is generic tenofovir disoproxil fumarate at $325 per year” (opens the original PMC page at this quote in a new tab)View highlighted excerpt for this quoteCopyFlag

“we used an annual antiviral drug cost of $502 with the assumption that 60% of the patients will be dispensed generic tenofovir disoproxil fumarate and 40% generic entecavir.” (opens the original PMC page at this quote in a new tab)View highlighted excerpt for this quoteCopyFlag

“we assumed that they will receive initial baseline tests (hepatitis B e antigen, complete blood count, complete metabolic panel, HBV DNA), and twice yearly clinic visits with alanine aminotransferase blood tests and yearly HBV DNA viral load tests, and that eligible patients (50%) would receive additional hepatocellular carcinoma surveillance consisting of liver ultrasound and α-fetoprotein every 6 months” (opens the original PMC page at this quote in a new tab)View highlighted excerpt for this quoteCopyFlag

“Based on recent data, it was estimated that there are 300,000 individuals diagnosed with chronic hepatitis B in the US, 13,900 chronic cases diagnosed annually, and 143,500 individuals on antiviral treatment.” (opens the source at this quote in a new tab)CopyFlag

“Annual costs for HBV medication under the base scenario were estimated at $5382 ($362–$12,310) based on drug sales data.” (opens the source at this quote in a new tab)CopyFlag

“The net prices of HBV medicine in the US are not publicly available.” (opens the source at this quote in a new tab)CopyFlag

“Between 2020 and 2050, it was projected that the United States would spend $44,822 million (40,920–51,994 million) cumulatively in direct medical costs associated with HBV.” (opens the source at this quote in a new tab)CopyFlag