Assessment of total economic burden of CHB related diseases in China

Presenter: Min Hu, Fudan University, School of Public Health

Abstract

Objective: To estimate the total annual cost due to CHB-related diseases imposed on each patient and his/her family in Beijing and Guangzhou, China.

Methods: Economic burden of four disease states associated with CHB (CHB, compensated cirrhosis, decompensated cirrhosis and hepatocellular carcinoma) were examined. A retrospective cohort of 328 patients in Beijing and 271 in Guangzhou were identified to obtain their socioeconomic status, utilization and costs of treatment and work-loss days due to illness with structured questionnaire. Costs of hospitalization were extracted from databases of two hospitals in Beijing and Guangzhou Social Insurance Information System respectively. The outpatient expenditure per patient was measured through the rate of outpatient visits and average cost per visit reported by the patients, while the inpatient cost was calculated through annual rate of hospitalization and average expenditure for different types of hospitals. Self medication and direct non-medical cost were also reported. Human Capital Approach was employed to measure the work-loss cost.

Results: The total annual cost per patient were as follows: US$1,636 for CHB, US$2,722 for compensated cirrhosis, US$4,611 for decompensated cirrhosis, and US$6,615 for primary hepatocellular carcinoma in Beijing, whilst in Guangzhou the costs were US$1,452, US$2,065, US$4,290 and US$6,054 for CHB, compensated cirrhosis, decompensated cirrhosis and hepatocellular carcinoma, respectively.

Conclusion: This study confirms that CHB-related diseases impose a substantial economic burden on patients, families and society in China urban areas. The study provides useful information on cost of treatment and work-loss for different disease states and also demonstrates disease progression relates to increasing healthcare costs. These can be further utilized in cost-effectiveness evaluation of treatment intervention.