UNDERSTANDING THE GLOBAL ECONOMIC BURDEN OF HEPATITIS DELTA VIRUS: A SYSTEMATIC LITERATURE REVIEW
Author(s)
Robert J. Wong, MD1, Arman Papadakis-Sali, MSc2, Pankaj Rai, MS3, Chong H Kim, MPH, MS, PhD4, Barinder Singh, RPh3, Marvin Rock, MPH, DrPH4, Robert G. Gish, MD5;
1Stanford University School of Medicine, Palo Alto, CA, USA, 2Gilead Sciences, Inc., Stockley Park, United Kingdom, 3Pharmacoevidence Private Limited, Mohali, India, 4Gilead Sciences, Inc., Foster City, CA, USA, 5Robert G. Gish Consultants, LLC, San Diego, CA, USA
1Stanford University School of Medicine, Palo Alto, CA, USA, 2Gilead Sciences, Inc., Stockley Park, United Kingdom, 3Pharmacoevidence Private Limited, Mohali, India, 4Gilead Sciences, Inc., Foster City, CA, USA, 5Robert G. Gish Consultants, LLC, San Diego, CA, USA
OBJECTIVES: Evaluating the impact of hepatitis delta virus (HDV) on healthcare resource utilization (HCRU) and costs is essential for assessing emerging treatments. This systematic literature review (SLR) aims to synthesize global evidence on the economic burden of patients with HDV infection.
METHODS: Embase, MEDLINE, and relevant conferences were searched from database inception to August 2025 to identify the studies reporting the economic burden of HDV. Citations were screened in parallel by a human reviewer and an artificial intelligence tool using predefined eligibility criteria with conflicts resolved by a subject matter expert.
RESULTS: The SLR identified 21 studies conducted across the US (n=8), Italy (n=4), Spain (n=4), China, Israel, South Korea, Germany, and France (n=1 each). Globally, patients with HDV consistently reported substantially higher mean annual cost and HCRU compared to patients with HBV monoinfection. Across the US, HDV patients reported significantly higher mean annual direct cost ($11,197-$50,642 vs $9,281-$25,632) and all-cause HCRU (20.3-36.4 vs 15.9-27.7 claims) compared with HBV monoinfection. The primary cost drivers for HDV patients were inpatient admissions ($220-$17,649), outpatient visits ($2,471-$9,951), and pharmacy costs ($5,722-$13,310), while HCRU burden was largely attributable to outpatient visits (8.6-16.8). No US studies reported indirect costs; however, a Spanish study estimated indirect costs of €12,717,573 over one year among 1,410 HDV patients, primarily driven by premature mortality (64.5%). Worldwide, the economic burden was more pronounced among HDV patients with advanced liver diseases, reflected by significantly higher costs and HCRU (P <.05) and particularly longer hospital stays (P <.0001), compared with those without liver diseases.
CONCLUSIONS: HDV imposes a substantial economic burden, with significantly higher healthcare costs and HCRU compared with HBV monoinfection and further increases with advanced liver diseases. These findings highlight the need for improved public health strategies, resource planning, and evaluation of emerging treatment options to mitigate the growing impact of HDV.
METHODS: Embase, MEDLINE, and relevant conferences were searched from database inception to August 2025 to identify the studies reporting the economic burden of HDV. Citations were screened in parallel by a human reviewer and an artificial intelligence tool using predefined eligibility criteria with conflicts resolved by a subject matter expert.
RESULTS: The SLR identified 21 studies conducted across the US (n=8), Italy (n=4), Spain (n=4), China, Israel, South Korea, Germany, and France (n=1 each). Globally, patients with HDV consistently reported substantially higher mean annual cost and HCRU compared to patients with HBV monoinfection. Across the US, HDV patients reported significantly higher mean annual direct cost ($11,197-$50,642 vs $9,281-$25,632) and all-cause HCRU (20.3-36.4 vs 15.9-27.7 claims) compared with HBV monoinfection. The primary cost drivers for HDV patients were inpatient admissions ($220-$17,649), outpatient visits ($2,471-$9,951), and pharmacy costs ($5,722-$13,310), while HCRU burden was largely attributable to outpatient visits (8.6-16.8). No US studies reported indirect costs; however, a Spanish study estimated indirect costs of €12,717,573 over one year among 1,410 HDV patients, primarily driven by premature mortality (64.5%). Worldwide, the economic burden was more pronounced among HDV patients with advanced liver diseases, reflected by significantly higher costs and HCRU (P <.05) and particularly longer hospital stays (P <.0001), compared with those without liver diseases.
CONCLUSIONS: HDV imposes a substantial economic burden, with significantly higher healthcare costs and HCRU compared with HBV monoinfection and further increases with advanced liver diseases. These findings highlight the need for improved public health strategies, resource planning, and evaluation of emerging treatment options to mitigate the growing impact of HDV.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE443
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies, Work & Home Productivity - Indirect Costs
Disease
SDC: Infectious Disease (non-vaccine)