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VALUE IN HEALTH 2ND SPECIAL ISSUE
PHARMACOECONOMICS AND OUTCOMES RESEARCH IN ASIA

M. Hu and W. Chen

ASSESSMENT OF TOTAL ECONOMIC BURDEN OF CHRONIC HEPATITIS B (CHB) RELATED DISEASES IN BEIJING AND GUANGZHOU, CHINA
Value in Health Supplemental Information


Table 1 Socioeconomic status of sampling patients in Beijing and Guangzhou

 

Beijing

Guangzhou

CHB

(n=152)

compensated cirrhosis

(n=71)

decompensated cirrhosis

(n=52)

hepatocellular carcinoma

(n=53)

CHB

(n=124)

compensated cirrhosis

(n=44)

decompensated cirrhosis

(n=55)

hepatocellular carcinoma

(n=48)

Gender

 

 

*

 

 

 

 

 

Male

100

(66%)

53

(75%)

37

(71%)

44

(83%)

71

(57%)

37

(84%)

48

(88%)

45

(94%)

Female

52

(34%)

18

(25%)

15

(29%)

9

(17%)

53

(43%)

7

(16%)

7

(12%)

3

(6%)

Age

44±14

50±12

53±10

55±11

38±17

50±13

52±12

50±15

Occupation

 

 

 

 

 

 

 

 

Civil Servant or employee

88

(59%)

45

(64%)

21

(41%)

23

(43%)

68

(55%)

20

(45%)

23

(42%)

20

(42%)

Retired

31

(20%)

14

(20%)

17

(33%)

21

(40%)

17

(13%)

7

(16%)

10

(18%)

12

(25%)

Unemployed

10

(7%)

6

(8%)

5

(10%)

3

(6%)

11

(9%)

11

(25%)

6

(11%)

4

(8%)

Others

21

(14%)

6

(8%)

8

(16%)

6

(11%)

27

(23%)

6

(14%)

16

(29%)

12

(25%)

Health Insurance coverage

*

 

 

 

 

 

 

Insured

122

(84%)

63

(89%)

41

(80%)

43

(83%)

69

(56%)

31

(70%)

37

(67%)

36

(75%)

Non-insured

24

(16%)

8

(11%)

10

(20%)

9

(17%)

54

(44%)

13

(30%)

18

(33%)

12

(25%)

Number of family members

2.9±1.5

3.1±1.0

3.2±1.1

3.1±0.9*

3.8±1.8

4.0±1.5

4.9±2.4

4.2±2.2

Monthly household income (US$)

651±1,245

842±1,729

554±429

604±617

651±551

673±1,392

484±327

898±1,858

Monthly household income (median, US$)

435

536

486

449

507

319

435

435

Note: Percentage in bracket, mean±standard deviation for quantitative data

*: p<0.05 compared with Guangzhou for the same category of socioeconomic characteristics;

†: p<0.01 compared with Guangzhou for the same category of socioeconomic characteristics

 

Table 2 Utilization of medical treatment of sampling patients in Beijing and Guangzhou

 

Beijing

Guangzhou

CHB

(n=152)

compensated cirrhosis

(n=71)

decompensated cirrhosis

(n=52)

hepatocellular carcinoma

(n=53)

CHB

(n=124)

compensated cirrhosis

(n=44))

decompensated cirrhosis

(n=55))

hepatocellular carcinoma

(n=48)

Outpatient visit in last 3 months

 

 

 

 

 

 

 

 

Proportion of patients having out-patient visits

68%

88%

70%

63%

48%

80%

60%

54%

Out-patient rate

1.3±1.2

2.1±1.6

1.3±1.2

1.2±1.2

1.8±3.2

1.9±2.0

2.0±2.8

1.1±1.6

Inpatient Visit in last 12 months

 

 

 

 

 

 

 

 

Proportion of patients having inpatients

11%

23%

74%

72%

21%

34%

58%

56%

    In-patient rate

0.1±0.4*

0.3±0.7

1.2±1.0

1.6±1.6

0.3±0.6

0.4±0.7

0.9±1.0

1.0±1.3

In which institution,

 

 

 

 

 

 

 

 

Community health center

0%

6%

8%

1%

0%

0%

4%

2%

Secondary hospital

9%

6%

8%

0%

14%

5 %

28%

9%

Tertiary hospital

91%

88%

84%

99%

86%

95%

68%

89%

Note: mean±standard deviation for quantitative data

*: p<0.05, compared with outpatient/inpatient visits in Guangzhou under the same disease state

 

Table 3 Cost of medical services and pharmaceutical treatment in Beijing and Guangzhou (US$)

 

Beijing

Guangzhou

CHB

compensated cirrhosis

decompensated cirrhosis

hepatocellular carcinoma

CHB

compensated cirrhosis

decompensated cirrhosis

hepatocellular carcinoma

Expenditure per outpatient visit

110±143†

133±98†

268±711*

263±381

82±131

83±48

123±188

201±199

Expenditure per hospitalization stay at different hospital levels

 

 

 

 

 

 

 

 

Community health center

NA

208

226

283

NA

NA

456

361

Secondary hospital

1,033

520

565

699

966

1,048

1,140

893

Tertiary hospital

1,824

1,227

1,335

2,638

1,706

2,475

2,692

3,370

Expenditure of medicines self-purchased in retail pharmacies per patient in last 6 months

94±236

67±189

125±259

109±270

87±244

27±91

169±413

138±457

Note: Mean±standard deviation for quantitative data

*: p<0.05, compared with medical expenditure in Guangzhou under the same disease state

†: p<0.01, compared with medical expenditure in Guangzhou under the same disease state


Table 4 Direct medical cost per patient with CHB-related diseases in Beijing and Guangzhou (US$)

 

Beijing

Guangzhou

CHB

compensated cirrhosis

decompensated cirrhosis

hepatocellular carcinoma

CHB

compensated cirrhosis

decompensated cirrhosis

hepatocellular carcinoma

Annul outpatient cost

591±912

(59%)

1,128±1,184

(72%)

1,416±3,915

(46%)

1,251±2,222

(23%)

602±1,411

(50%)

626±758

(37%)

996±2,040

(26%)

868±1,556

(20%)

Annul inpatient cost

228

(22%)

302

(19%)

1,426

(46%)

4,048

(73%)

432

(36%)

1,031

(60%)

1,833

(49%)

3,137

(73%)

Annul cost of medicines self-purchased in retail pharmacies

188±334

(19%)

134±267

(9%)

251±366

(8%)

218±382

(4%)

175±345

(14%)

55±129

(3%)

338±584

(25%)

276±646

(7%)

Total

1,007

1,564

3,093

5,517

1,209

1,712

3,167

4,281

Note: Percentage in bracket, mean±standard deviation for quantitative data

 

Table 5 Direct non-medical cost per patient with CHB-related diseases in Beijing and Guangzhou (US$)

 

Beijing

Guangzhou

CHB

compensated cirrhosis

decompensated cirrhosis

hepatocellular carcinoma

CHB

compensated cirrhosis

decompensated cirrhosis

hepatocellular carcinoma

Annual cost of health products

202±494*

(54%)

428±816†

(60%)

578±1,146*

(74%)

411±936

(72%)

125±299

(86%)

83±210

(51%)

378±970

(58%)

1,098±2,266

(92%)

Annual cost of transportation

171±579†

(46%)

290±1,268

(40%)

199±273

(26%)

156±322†

 (28%)

21±64

 (14%)

80±130

(49%)

271±513

(42%)

93±183

(8%)

Total

373±761

718±1,508

777±1,178

567±990

146±140

163±154

649±637

1,191±1,113

Note: Percentage in bracket, mean±standard deviation for quantitative data

*: p<0.05, compared with cost of health products/transportation in Guangzhou under the same disease state

†: p<0.01, compared with cost of health products/transportation in Guangzhou under the same disease state

 


Table 6 Indirect economic burden per patient with CHB-related diseases in Beijing and Guangzhou (US$)

 

Beijing

Guangzhou

CHB

compensated cirrhosis

decompensated cirrhosis

hepatocellular carcinoma

CHB

compensated cirrhosis

decompensated cirrhosis

hepatocellular carcinoma

Patient

 

 

 

 

 

 

 

 

Sick-leave days per month

1.5±5.5

2.5±6.9

3.5±7.0

2.5±6.4

0.6±3.3

1.7±6.4

3.3±8.4

3.3±8.3

Patient income per month (US$)

298±229*

308±227

280±386

221±114

270±285

200±269

192±178

258±230

Annul indirect economic burden

179±671

(70%)

308±880

(70%)

392±952

(53%)

221±577

(42%)

65±364

(67%)

136±544

(72%)

253±685

(53%)

340±907

(58%)

Family members

 

 

 

 

 

 

 

 

Leave days per month

1.0±4.2†

1.7±5.4*

4.5±7.5

4.0±5.8

0.6±2.3

1.0±4.7

4.1±8.4

4.5±8.5

Annul indirect economic burden

77±347

(30%)

132±472

(30%)

349±815

(47%)

310±678

(58%)

32±130

(33%)

54±264

(28%)

221±542

(47%)

242±562

(42%)

Total cost

256±431

440±645

741±1,101

531±861

97±162

190±325

474±720

582±809

Note: Percentage in bracket, mean±standard deviation for quantitative data

*: p<0.05, compared with patient income per month/leave days per month in Guangzhou under the same disease state

†: p<0.01, compared with patient income per month/leave days per month in Guangzhou under the same disease state

 

Table 7 Total economic burden per patient with CHB-related diseases in Beijing and Guangzhou (US$)

 

Beijing

Guangzhou

CHB

compensated

cirrhosis

decompensated

cirrhosis

hepatocellular

carcinoma

CHB

compensated

cirrhosis

decompensated

cirrhosis

hepatocellular

carcinoma

Direct economic burden

1,380

(84%)

2,282

(84%)

3,870

(84%)

6,084

(92%)

1,355

(93%)

1,875

(91%)

3,816

(89%)

5,472

(90%)

Direct medical cost

1,007

(61%)

1,564

(58%)

3,093

(67%)

5,517

(83%)

1,209

(83%)

1,712

(83%)

3,167

(74%)

4,281

(70%)

Direct non-medical cost

373±761

(23%)

718±1,508

(26%)

777±1,178

(17%)

567±990

(9%)

146±140

(10%)

163±154

(8%)

649±637

(15%)

1,191±1,113

(20%)

Indirect economic burden

256±431

(16%)

440±645

(16%)

741±1,101

(16%)

531±861

(8%)

97±162

(7%)

190±325

(9%)

474±720

(11%)

582±809

(10%)

Total economic burden

1,636

(100%)

2,722

(100%)

4,611

(100%)

6,615

(100%)

1,452

(100%)

2,065

(100%)

4,290

(100%)

6,054

(100%)

Note: Percentage in bracket, mean±standard deviation for quantitative data

 


Figure 1 Economic burden of CHB-related diseases and economic indicators in Beijing and Guangzhou

 



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