OBJECTIVES: To estimate the disease burden of the progressive chronic Hepatitis B (CHB) in China.

METHODS: A decision-analytic model was constructed to simulate the Chinese patients with progressive CHB and the age and gender-matched Chinese general population over lifetime time horizon for the differences in overall survival, quality-adjusted life years (QALY), and lifetime direct medical costs. A literature search was conducted to estimate the model variables. Base case analysis and sensitivity analysis were conducted for the point estimations and uncertainty of the disease burden of progressive CHB.

RESULTS: The base case analysis estimated that the progressive CHB patients were associated with reduced overall survival by 17.866 years (24.067 years vs. 41.934 years), reduced average QALY by 20.717 QALY (17.153 QALY vs. 37.870 QALY), and increased average life-time direct medical costs by ¥64,774 (¥261,163 vs. ¥196,389). The reduced QALY associated with progressive CHB was sensitive to patient age of fibrosis stage 1 (change: 2.796 QALY), 2(change: 2.426 QALY,) and 4 (2.323 QALY), and the utility of fibrosis stage 1 (change: 1.891 QALY) and 2 (change: 1.864 QALY). The increased lifetime direct medical costs associated with progressive CHB was sensitive to mortality of hepatocellular carcinoma (change: ¥-80,991) and decompensated cirrhosis (change: ¥-49,701), patient age of fibrosis stage 1 (change: ¥-44,824) and 4 (change: ¥-45,011), and medical cost associated with decompensated cirrhosis (change: ¥44,407). The probabilistic sensitivity analysis with 10,000 Monte Carlo simulations estimated the median and 95% credible interval of reduced QALY (-20.550 QALY, -21.673 QALY to -19.317 QALY) and increased lifetime direct medical costs (¥68,948, ¥25,153 to ¥132,781).

CONCLUSIONS: The disease burden of progressive CHB in China was characterized by reduced overall survival, reduced QALY, and increased medical costs that were sensitive to patient age and utility associated with fibrosis stages and the mortality and medical costs of long-term complications.