Investment case for a comprehensive package of interventions against Hepatitis B in China; applied modelling to help national strategy planning
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Background:In2016,the first globalviralhepatitiselimination targetswere endorsed. Anestimated one-third of the world’schronic HBV infected population 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 countriesto 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:Adynamic simulation modelof HBV was developedand 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:Despitethe successes of historical vaccination scale-up since 1992, there will be a projected 60millionpeople still living with HBV in 2030 and 10 million HBV-related deaths, including 5.7millionHBV-related cancer deaths between 2015-2030. This could be reduced by 2.1million 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 1.57US$ per US$ invested. Conclusions:Increases in HBV-related deaths for the next few decades pose a major public health threatin China. Active case-finding and access to optimal antiviral treatment is requiredto mitigate this risk. This investment case approachprovides a real-world example of howapplied modellingcansupportnational dialogue and inform policy planning.
Date Issued
2021-03-01
Date Acceptance
2020-02-11
Citation
Clinical Infectious Diseases, 2021, 72 (5), pp.743-752
ISSN
1058-4838
Publisher
Oxford University Press (OUP)
Start Page
743
End Page
752
Journal / Book Title
Clinical Infectious Diseases
Volume
72
Issue
5
Copyright Statement
© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
License URL
Sponsor
Medical Research Council (MRC)
Imperial College Healthcare NHS Trust: Research Capability Funding (RCF)
Grant Number
MR/R015600/1
RDF04
Subjects
China
antiviral treatment
hepatitis B
investment case
modeling
06 Biological Sciences
11 Medical and Health Sciences
Microbiology
Publication Status
Published
Date Publish Online
2020-04-07