PIN16 Disease Burden of Progressive Chronic Hepatitis B in China

Abstract

To estimate the disease burden of the progressive chronic Hepatitis B (CHB) in China. A decision-analytic model was constructed to simulate the Chinese patients with progressive CHB and the age and gender-matched Chinese general population over lifetime time horizon for the differences in overall survival, quality-adjusted life years (QALY), and lifetime direct medical costs. Literature search was conducted to identify appropriate evidence to estimate the model variables. Base case analysis and sensitivity analysis were conducted for the point estimations and uncertainty of the disease burden of CHB. The base case analysis estimated that the progressive CHB patients were associated with reduced overall survival by 17.866 years (24.067 years vs. 41.934 years), reduced average QALY by 20.717 QALY (17.153 QALY vs. 37.870 QALY), and increase average life-time direct medical costs by ¥64,774 (¥261,163 vs. ¥196,389). The QALY associated with progressive CHB was highly sensitive to patient age of fibrosis stage 1 (change: 2.796 QALY), 2(change: 2.426 QALY,) and 4, (2.323 QALY),quality of life of fibrosis stage 1 (change: 1.891 QALY) and 2 (change: 1.864 QALY). The lifetime direct medical costs associated with CHB was highly sensitive to mortality of hepatocellular carcinoma(change: ¥-80,991) and decompensated cirrhosis (change: ¥-49,701), patient age of fibrosis stage 1(change: ¥-44,824) and 4 (change: ¥-45,011), direct medical cost associated with decompensated cirrhosis (change: ¥44,407). The probabilistic sensitivity analysis with 10,000 Monte Carlo simulations estimated that the median and 95% credible interval of reduced QALY (-20.550 QALY, -21.673 QALY to -19.317 QALY) and increased lifetime direct medical costs (¥68,948, ¥25,153 to ¥132,781). The disease burden of progressive CHB in China was mainly characterized with reduced overall survival and reduced QALY that were highly sensitive to patient age associated with fibrosis and the risk of hepatocellular carcinoma.