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- Title
Investment Case for a Comprehensive Package of Interventions Against Hepatitis B in China: Applied Modeling to Help National Strategy Planning.
- Authors
Nayagam, Shevanthi; Chan, Polin; Zhao, Kun; Sicuri, Elisa; Wang, Xiaochun; Jia, Jidong; Wei, Lai; Walsh, Nick; Rodewald, Lance E; Zhang, Guomin; Ailing, Wang; Zhang, Lan; Chang, Joo H; Hou, WeiWei; Qiu, Yingpeng; Sui, Binyan; Xiao, Yue; Zhuang, Hui; Thursz, M R; Scano, Fabio
- Abstract
Background In 2016, the first global viral hepatitis elimination targets were endorsed. An estimated one-third of the world's population of individuals with chronic hepatitis B virus (HBV) infection live in China and liver cancer is the sixth leading cause of mortality, but coverage of first-line antiviral treatment was low. In 2015, China was one of the first countries to initiate a consultative process for a renewed approach to viral hepatitis. We present the investment case for the scale-up of a comprehensive package of HBV interventions. Methods A dynamic simulation model of HBV was developed and used to simulate the Chinese HBV epidemic. We evaluated the impact, costs, and return on investment of a comprehensive package of prevention and treatment interventions from a societal perspective, incorporating costs of management of end-stage liver disease and lost productivity costs. Results Despite the successes of historical vaccination scale-up since 1992, there will be a projected 60 million people still living with HBV in 2030 and 10 million HBV-related deaths, including 5.7 million HBV-related cancer deaths between 2015 and 2030. This could be reduced by 2.1 million by highly active case-finding and optimal antiviral treatment regimens. The package of interventions is likely to have a positive return on investment to society of US$1.57 per US dollar invested. Conclusions Increases in HBV-related deaths for the next few decades pose a major public health threat in China. Active case-finding and access to optimal antiviral treatment are required to mitigate this risk. This investment case approach provides a real-world example of how applied modeling can support national dialog and inform policy planning.
- Subjects
CHINA; HEPATITIS B prevention; HEPATITIS B; INVESTMENTS; HEALTH policy; STRATEGIC planning; ANTIVIRAL agents; MEDICAL care costs
- Publication
Clinical Infectious Diseases, 2021, Vol 72, Issue 5, p743
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/ciaa134