Healthcare Resource Utilisation and Costs Associated With Hepatitis B Virus Monoinfection Compared With Hepatitis Delta Virus Prior to Death Among Adults in Italy in the Outpatient Setting
Author(s)
Pietro Lampertico, MD, PhD1, Valentina Perrone, M.Pharm.2, Luca Degli Esposti, PhD2, Melania Leogrande, M.Sc.2, Chong H Kim, MPH, MS, PhD3, Marvin Rock, PhD3;
1University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy, 2Clicon Srl Società Benefit, Health, Economics & Outcomes Research, Bologna, Italy, 3Gilead Sciences, Inc., HEOR—Global Value & Access, Foster City, CA, USA
1University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy, 2Clicon Srl Società Benefit, Health, Economics & Outcomes Research, Bologna, Italy, 3Gilead Sciences, Inc., HEOR—Global Value & Access, Foster City, CA, USA
Presentation Documents
OBJECTIVES: Hepatitis delta virus (HDV) infection occurs in some patients infected with hepatitis B virus (HBV) and increases liver-related morbidity. Outpatient healthcare resource utilisation (HCRU) and costs in the year prior to death were compared among patients in Italy with HBV only vs HDV.
METHODS: Local health unit databases in Italy were screened for adults with ≥1 HBV or HDV outpatient claim(s) between 1/1/2009-30/6/2022. Included patients had a first HBV or HDV diagnosis between 1/1/2010-30/6/2021 and ≥12 months continuous enrolment before and after diagnosis. Inverse probability of treatment weighting (IPTW) was calculated using propensity scores (HBV or HDV infection probability given baseline covariates). Mean per-patient all-cause HCRU and costs were compared via Mann-Whitney U test between HBV only and HDV cohorts post-IPTW.
RESULTS: Of 1,242 outpatients meeting inclusion criteria (HBV only, n=1,112; HDV, n=130), 55 died. In the 12 months before death, there were no significant differences in mean (95% CI) per-patient all-cause outpatient visits (HBV, 10.4 [7.6-13.1] vs HDV, 18.4 [14.4-22.4]; P=0.097), pharmacy claims (HBV, 12.1 [10.1-14.0] vs HDV, 13.0 [11.5-14.4]; P=0.552), or drug costs (HBV, €5,558.2 [€1,568.5-9,547.8] vs HDV, €12,741.3 [€8,766.1-16,716.5]; P=0.13); mean (95% CI) per-patient all-cause outpatient cost was lower for HBV only (€2,608.8 [€824.6-4,393.0]) vs HDV (€6,188.6 [€4,721.9-7,655.2]; P=0.013). In the 6 months before death, there were no significant differences in mean (95% CI) outpatient visits (HBV, 4.9 [3.5-6.3] vs HDV, 9.4 [7.3-11.6]; P=0.094), pharmacy claims (HBV, 9.4 [7.8-11.1] vs HDV, 10.0 [8.8-11.2]; P=0.804), or drug costs (HBV, €2,269.1 [€591.8-3,946.3] vs HDV, €6,885.1 [€4,692.7-9,077.5]; P=0.089); mean (95% CI) per-patient all-cause outpatient cost was lower for HBV only (€1,148.7 [€347.0-1,950.4]) vs HDV (€3,249.6 [€2,379.7-4,119.6]; P=0.011).
CONCLUSIONS: Despite having similar HCRU rates as HBV-only patients, mean per-patient outpatient cost was higher for those with HDV in their last year of life, highlighting a need for treatments that reduce HDV economic burden.
METHODS: Local health unit databases in Italy were screened for adults with ≥1 HBV or HDV outpatient claim(s) between 1/1/2009-30/6/2022. Included patients had a first HBV or HDV diagnosis between 1/1/2010-30/6/2021 and ≥12 months continuous enrolment before and after diagnosis. Inverse probability of treatment weighting (IPTW) was calculated using propensity scores (HBV or HDV infection probability given baseline covariates). Mean per-patient all-cause HCRU and costs were compared via Mann-Whitney U test between HBV only and HDV cohorts post-IPTW.
RESULTS: Of 1,242 outpatients meeting inclusion criteria (HBV only, n=1,112; HDV, n=130), 55 died. In the 12 months before death, there were no significant differences in mean (95% CI) per-patient all-cause outpatient visits (HBV, 10.4 [7.6-13.1] vs HDV, 18.4 [14.4-22.4]; P=0.097), pharmacy claims (HBV, 12.1 [10.1-14.0] vs HDV, 13.0 [11.5-14.4]; P=0.552), or drug costs (HBV, €5,558.2 [€1,568.5-9,547.8] vs HDV, €12,741.3 [€8,766.1-16,716.5]; P=0.13); mean (95% CI) per-patient all-cause outpatient cost was lower for HBV only (€2,608.8 [€824.6-4,393.0]) vs HDV (€6,188.6 [€4,721.9-7,655.2]; P=0.013). In the 6 months before death, there were no significant differences in mean (95% CI) outpatient visits (HBV, 4.9 [3.5-6.3] vs HDV, 9.4 [7.3-11.6]; P=0.094), pharmacy claims (HBV, 9.4 [7.8-11.1] vs HDV, 10.0 [8.8-11.2]; P=0.804), or drug costs (HBV, €2,269.1 [€591.8-3,946.3] vs HDV, €6,885.1 [€4,692.7-9,077.5]; P=0.089); mean (95% CI) per-patient all-cause outpatient cost was lower for HBV only (€1,148.7 [€347.0-1,950.4]) vs HDV (€3,249.6 [€2,379.7-4,119.6]; P=0.011).
CONCLUSIONS: Despite having similar HCRU rates as HBV-only patients, mean per-patient outpatient cost was higher for those with HDV in their last year of life, highlighting a need for treatments that reduce HDV economic burden.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE18
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Infectious Disease (non-vaccine)