The Direct Medical Cost of Regular Monitoring of Patients with HBeAg-Negative Chronic Hepatitis B Virus Infection


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Emecen A. N., ÇAŞKURLU H., Ergen P., ÇAĞ Y., ARSLAN F., VAHABOĞLU H.

VIRAL HEPATIT DERGISI-VIRAL HEPATITIS JOURNAL, cilt.28, sa.2, ss.61-66, 2022 (ESCI) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 28 Sayı: 2
  • Basım Tarihi: 2022
  • Doi Numarası: 10.4274/vhd.galenos.2022.2021-12-1
  • Dergi Adı: VIRAL HEPATIT DERGISI-VIRAL HEPATITIS JOURNAL
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.61-66
  • Anahtar Kelimeler: Hepatitis B virus, chronic hepatitis B, hospital costs, health costs, direct service costs, INACTIVE CARRIERS, HBSAG, MANAGEMENT, TURKEY
  • Dokuz Eylül Üniversitesi Adresli: Hayır

Özet

Objectives: Patients with hepatitis B e antigen-negative chronic infection (inactive carriers) account for most of the people living with hepatitis B virus (HBV). This study investigated the direct medical cost of monitoring patients within this group.Materials and Methods: A total of 293 outpatients receiving regular monitoring in a large university hospital were included in the study. Direct medical costs included laboratory tests, imaging, liver biopsies and co-payments. Linear mixed effect models were applied to investigate the effect of follow-up time on the annual cost of monitoring. We made quarterly, semi-annual and annual monitoring cost trajectories in accordance with international guideline recommendations.Results: The average annual direct medical cost per patient was 160 USD and the average laboratory visit cost per patient was 68.5 USD. HBV DNA testing contributed to a majority percentage of the total cost (59.6%). As follow-up time increased, the total annual cost (beta=-2.07) and annual cost for DNA testing (beta=-1.03) decreased. The cost trajectory of the first two years of monitoring remained above the semi-annual follow-up strategy. After three years, the cost trajectory of monitoring, while reducing slightly, remained between the semi-annual and annual follow-up strategy trend lines. Conclusion: Due to high-patient numbers, the total cost of monitoring presents a large economic burden. Taking into consideration the generally benign nature of the disease; the length of intervals between outpatient hospital visits could be reviewed and alternative strategies implemented with the aim of reducing expenditure.