HBV-Infektionen in Deutschland – Versorgungskosten in einem Real-life-Setting

Abstract

An estimated 500 000 people are infected with hepatitis B in Germany, inducing an enormous burden on infected patients and the health care system. The aim of our study was to estimate the real-life costs of treating hepatitis B and to analyze sociodemographic factors. We conducted a retrospective, non-interventional, single-center study from 07/2009 to 12/2012. Information on health care delivery was extracted from patient records. Besides that, a questionnaire survey regarding sociodemographic parameters and quality of life of HBV-infected patients was performed. A total of 117 patients were included in our study and grouped in six different disease stages. The response rate of our survey was 80 %. We determined annual total costs of € 3509. The different groups altered between € 221 and € 5618. The main costs (80 %) were caused by the antiviral therapy. Costs of co-medication and hospitalizations were of minor importance. Laboratory costs were primarily caused by determination of virological parameters. Route of transmission of HBV-infection was unknown in 2/3 of all cases. Restrictions in quality of life due to the HBV-infection were reported by 60 % of the patients. Patients receiving interferon treatment reported highest restrictions. In an extrapolation, we estimated total annual hepatitis B treatment costs of 430 million € in Germany. This is the first study estimating real-life treatment costs of hepatitis B infections in Germany. Further research should follow in the context of newly introduced generic antivirals.

Indication for treatment and severity of disease in treatment-naive patients with chronic hepatitis B virus infection

“…The higher proportion of male patients with HBV-infections also matches the higher HBV-prevalence in men that is reported in Germany. 13,20,21,24,25 EASL guidelines establish criteria for treatment initiation which include non-invasive markers such as HBV-DNA and ALT levels and transient elastrography. While liver biopsy remains the gold standard for the assessment of liver fibrosis and necro-inflammatory activity, it has largely been replaced by these non-invasive markers, particularly in the ambulatory setting.…”