--- title: "Hibsago (bepirovirsen) in Chronic hepatitis B virus infection in adults without cirrhosis: Economic burden and healthcare resource utilization" description: "Formulary evidence on Hibsago (bepirovirsen, GSK3228836) in Chronic hepatitis B virus infection in adults without cirrhosis: Economic burden and healthcare resource utilization. Topics: Annual all-cause healthcare costs by disease severity: U.S. Commercial, Medicare, and Medicaid claims, 2004 to 2015; Inpatient cost share and inpatient use by disease severity in the same claims study; Inpatient costs of hospitalizations with chronic hepatitis B: National Inpatient Sample, 2016 to 2019; Medicare beneficiaries with chronic hepatitis B: outcomes and charges, 2005 to 2014; 6 further topics. 10 evidence topics quoted from 9 sources." canonical: "https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/product-information-and-disease-description/economic-burden-and-healthcare-resource-utilization" published: "2026-10-21T22:39:04-04:00" modified: "2026-10-22T19:07:03-04:00" --- # Hibsago (bepirovirsen) in Chronic hepatitis B virus infection in adults without cirrhosis: Economic burden and healthcare resource utilization ## 2.2.1.8.2 Economic Burden and Healthcare Resource Utilization ### Annual all-cause healthcare costs by disease severity: U.S. Commercial, Medicare, and Medicaid claims, 2004 to 2015 > “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.” > “Our sample consisted of 33,904 CHB cases and 86,072 non-CHB controls.” > “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).” > “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).” > “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).” > “Compensated liver disease: 98% non-cirrhotic CHB; 2% compensated cirrhosis.” Source: [Nguyen et al. (2019)](https://doi.org/10.1016/j.jhep.2018.09.021) ### Inpatient cost share and inpatient use by disease severity in the same claims study > “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%).” > “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).” > “Across all payers, patients with decompensated cirrhosis had the highest emergency department utilization (1.6–2.8 annual visits) and highest mean annual costs.” Source: [Nguyen et al. (2019)](https://doi.org/10.1016/j.jhep.2018.09.021) ### Inpatient costs of hospitalizations with chronic hepatitis B: National Inpatient Sample, 2016 to 2019 > “The 2016–2019 National Inpatient Sample was used to select individuals diagnosed with CHB.” > “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.” > “We did not observe significant cost trends in the composite CHB population or in the cirrhosis and non-cirrhosis cohorts.” Source: [Lee et al. (2024)](https://pmc.ncbi.nlm.nih.gov/articles/PMC11257816/) ### Medicare beneficiaries with chronic hepatitis B: outcomes and charges, 2005 to 2014 > “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.” > “Furthermore, 7.4% of CH-B Medicare cohort experienced decompensated cirrhosis, 2.9% hepatocellular carcinoma (HCC) and 11.9% 1-year mortality.” > “Annual total inpatient charges increased from $66,610 to $94,221 while these charges for outpatient increased from $9257 to $47,863.” Source: [Kim et al. (2019)](https://pubmed.ncbi.nlm.nih.gov/30106839/) ### Veterans Health Administration: total costs and nucleos(t)ide analogue persistence > “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.” > “Persistence among the inception cohort was 29% for first year and 14% for first 2 years.” Source: [Sbarigia et al. (2020)](https://pmc.ncbi.nlm.nih.gov/articles/PMC7089729/) ### Medicaid spending on nucleos(t)ide analogues, 2012 to 2021 > “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.” Source: [Congly et al. (2024)](https://pubmed.ncbi.nlm.nih.gov/38710472/) ### Average wholesale prices of nucleos(t)ide analogues: Vermont prescriber price disclosure, January 2024 > “The prices listed below are Average Wholesale Prices” > “The price paid by consumers may be higher or lower than the prices listed below.” > “Wholesale Acquisition Cost (WAC) plus 20%” > “Source: First Databank, 01/28/2024.” Source: [Gilead Sciences (2024)](https://www.gilead.com/-/media/files/pdfs/other/vemlidy-long-form.pdf) | Product | Labeler as listed | Package | Package price (AWP) | Unit price (AWP) | | --- | --- | --- | --- | --- | | Tenofovir alafenamide 25 mg tablet (Vemlidy) | “Gilead Sciences” | “30 EA” | “$1,729.91” | “$57.66” | | Entecavir 0.5 mg tablet (Baraclude) | “Bms Primarycare” | “30 EA” | “$1,646.98” | “$54.90” | | Entecavir 0.5 mg tablet, generic, lowest listed | “Epic Pharma Llc” | “30 EA” | “$9.60” | “$0.32” | | Entecavir 0.5 mg tablet, generic | “Camber Pharmace” | “30 EA” | “$48.00” | “$1.60” | | Entecavir 0.5 mg tablet, generic, highest listed | “Marlex Pharm.” | “30 EA” | “$864.00” | “$28.80” | | Adefovir dipivoxil 10 mg tablet, generic | “Apotex Corp” | “30 EA” | “$1,074.00” | “$35.80” | Source: [Gilead Sciences (2024)](https://www.gilead.com/-/media/files/pdfs/other/vemlidy-long-form.pdf) ### Annual antiviral drug and monitoring cost inputs in a U.S. cost-effectiveness model (2021 U.S. dollars) > “Although the lowest price for antiviral drugs is generic tenofovir disoproxil fumarate at $325 per year” > “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.” > “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” Source: [Hutton et al. (2022)](https://pmc.ncbi.nlm.nih.gov/articles/PMC9188991/) ### Annual medical management costs by disease stage used in a U.S. hepatitis D testing cost-effectiveness model (2024 U.S. dollars) | Health state | Base value | Range | | --- | --- | --- | | Cirrhosis | “$5964” | “$202–$7096” | | Decompensated cirrhosis | “$15 795” | “$4901–$37 081” | | Liver transplantation, first year | “$215 162” | “$167 163–$250 746” | | Liver transplantation, second year | “$26 860” | “$23 958–$35 937” | Source: [Toy et al. (2025)](https://pmc.ncbi.nlm.nih.gov/articles/PMC12598672/) ### Projected U.S. direct medical costs, diagnosed population, and treated population: PRoGReSs model, 2020 to 2050 > “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.” > “Annual costs for HBV medication under the base scenario were estimated at $5382 ($362–$12,310) based on drug sales data.” > “The net prices of HBV medicine in the US are not publicly available.” > “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.” Source: [Razavi-Shearer et al. (2023b)](https://doi.org/10.1111/jvh.13843) ## Related pages - [Hibsago (bepirovirsen): Chronic hepatitis B virus infection in adults without cirrhosis](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis) · [Markdown](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis.md) - [Hibsago (bepirovirsen) in Chronic hepatitis B virus infection in adults without cirrhosis: Terms and abbreviations](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/terms-and-abbreviations) · [Markdown](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/terms-and-abbreviations.md) - [Hibsago (bepirovirsen): Chronic hepatitis B virus infection in adults without cirrhosis](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/executive-summary) · [Markdown](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/executive-summary.md) - [Hibsago (bepirovirsen) in Chronic hepatitis B virus infection in adults without cirrhosis: Product information and disease description](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/product-information-and-disease-description) · [Markdown](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/product-information-and-disease-description.md) - [Hibsago (bepirovirsen) in Chronic hepatitis B virus infection in adults without cirrhosis: Clinical evidence](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/clinical-evidence) · [Markdown](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/clinical-evidence.md) - [Hibsago (bepirovirsen) in Chronic hepatitis B virus infection in adults without cirrhosis: Economic information and modeling report](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/economics) · [Markdown](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/economics.md) - [Hibsago (bepirovirsen) in Chronic hepatitis B virus infection in adults without cirrhosis: References](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/references) · [Markdown](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/references.md) - [Hibsago (bepirovirsen) in Chronic hepatitis B virus infection in adults without cirrhosis: new drug review](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/monograph/review) · [Markdown](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/monograph/review.md) - [Hibsago (bepirovirsen) in Chronic hepatitis B virus infection in adults without cirrhosis: cost-effectiveness analyses and utility weights](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/cost-effectiveness-analyses) · [Markdown](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/cost-effectiveness-analyses.md)