Abstract
Background: Antiviral hepatitis B therapy has been included in the reimbursement list of medical insurance in Beijing since July 1, 2011. This study aimed to assess the impact of this reimbursement program on liver-related death for patients with Chronic Hepatitis B (CHB). Methods: Profiles of CHB patients discharged between 2008·1 and 2015·12 were retrieved from Hospital Discharge Database of Beijing. Liver-related deaths of these patients occurred between 2008·1 and 2017·12 were retrieved by linking to Death Certification Database. Liver-related mortality was calculated by dividing the number of deaths by their observed person-years. Poisson regression was performed to assess the strength of association (risk ratio, RR) between this reimbursement program and liver-related mortality. Findings: Information of 35,943 discharged CHB patients was retrieved. After launching this reimbursement program, liver-related mortality per 100 person-years dropped from 0·38% to 0·16% for non-cirrhotic CHB patients, and it also declined from 4·03% to 3·39% for cirrhotic CHB patients. This reimbursement program was associated with a lower risk of developing liver-related death for non-cirrhotic (RR=0·40, 95%CI: 0·30-0·52) and cirrhotic CHB patients (RR=0·84, 95%CI: 0·78-0·89). Interpretation: Coverage of antiviral therapy by basic medical insurance reduced the risk of developing liver-related death for non-cirrhotic and cirrhotic CHB patients. Ethical Approval: This study was approved by the Institutional Research Board of Beijing Friendship Hospital, Capital Medical University with waived requirement for patients’ informed consent approval number 2016-P2-024-01). Funding: This study was supported by Beijing Municipal Science and Technology Commission 8 (No·D161100002716003), the National Key Technologies R&D Program for New Drug Development (No·2018ZX09201016), and Beijing Nova Program (No·Z161100004916105). Competing Interest Declaration: The authors state: none.
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