Economic Burden of Hepatitis B Virus-Related Diseases: Evidence From Iran

Abstract

Background:Hepatitis B infection is still the main cause of chronic liver disease in Iran, which is associated with significant economic and social costs.Objectives:This study aimed to estimate the financial burden caused by CHB infection and its complications in Iran.Patients and Methods:Prevalence-based and bottom-up approaches were used to collect the data. Data on direct medical costs were extracted from outpatient medical records in a referral gastroenterology and hepatology research center, inpatient medical records in several major hospitals in Tehran and Shiraz in 2013, and the self-reports of specialists. Data on direct non-medical and indirect costs were collected based on the patients’ self-reports through face-to-face interviews performed in the mentioned centers. To calculate the indirect costs, friction cost approach was used. To calculate the total cost-of-illness in Iran, the total cost per patient at each stage of the disease was estimated and multiplied by the total number of patients.Results:The total annual cost for the activate population of CHB patients and for those receiving treatment at various disease stages were respectively 450 million and 226 million dollars, with 64% and 70% of which allocated to direct costs respectively, and 36% and 30% to indirect costs respectively. The total direct costs alone for each group were respectively 1.17% and 0.6% of the total health expenditure. Furthermore, the cost spent on drugs encompasses the largest proportion of the direct medical cost for all stages of the disease.Conclusions:According to the perspectives of payers, patients, and community, CHB infection can be considered as one of the diseases with a substantial economic burden; the disease, specifically in extreme cases, can be too expensive and costly for patients. Therefore, patients should be protected against more severe stages of the disease through proper treatment and early diagnosis.

A Cost-Utility and Cost-Effectiveness Analysis of Different Oral Antiviral Medications in Patients With HBeAg-Negative Chronic Hepatitis B in Iran: An Economic Microsimulation Decision Model

“…Currently, an estimated 350 million people worldwide have chronic HB (CHB) infection, which results in about 500,000 to 1.2 million deaths per year (3, 4). In Iran, according to the latest statistical data released by the office for the prevention of viral hepatitis in the ministry of health and medical education, the prevalence of hepatitis B in the country was estimated to be about 1.5% (5, 6). Given that the population of Iran was about 78 million in 2014 (7), the total number of chronic HB virus (HBV) carriers was estimated to be 1,170,000 people (5).…”

“…In Iran, according to the latest statistical data released by the office for the prevention of viral hepatitis in the ministry of health and medical education, the prevalence of hepatitis B in the country was estimated to be about 1.5% (5, 6). Given that the population of Iran was about 78 million in 2014 (7), the total number of chronic HB virus (HBV) carriers was estimated to be 1,170,000 people (5). The genotype D is the predominant genotype of hepatitis in the country (8, 9), and more than 70% of cases are HB e antigen (HBeAg) negative (10).…”

Economic Burden of Scorpion Sting and Snake Bite from a Social Perspective in Iran

“…The average total direct medical costs per each patient with scorpion sting and snake bite were separately calculated as follows (6,(18)(19)(20) Moreover, in order to make international comparisons in this study, we converted the costs using purchasing power parity with an exchange rate of 11222.4 Rials to international dollars (21).…”

“…The average total direct non-medical costs per patient with scorpion sting and snake bite were separately calculated as follows (6,(18)(19)(20):…”

“…In addition, because of the catastrophic costs of health-related services, the health system in Iran has been faced significant challenges (4,5). The costs may be imposed directly by the use of diagnostic and medical services or indirectly by the loss of productivity and quality of life (6). According to recent reports by the World Health Organization, more than 5 million cases of snake bites, scorpion sting, wasp sting, etc.…”