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
Moderator
Chong H Kim, MPH, MS, PhD, Gilead, Foster City, CA, United States
Speakers
Pietro Lampertico; Valentina Perrone; Luca Degli Esposti, PhD; Melania Leogrande; Marvin Rock
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)