title: A simulation shows that early treatment of chronic hepatitis B infection can cut deaths and be cost-effective.
abstract: Chronic hepatitis B affects between 800,000 and two million people in the United States and causes 4,000 deaths each year. Yet the costs and benefits of treatment have not been fully evaluated. Using a model that simulates disease progression, we compare treatment programs for hepatitis B that start at an early stage of the disease to treatment that begins at a late stage. Our analysis concludes that early hepatitis B care can improve health, reduce premature deaths, and prevent expensive complications, making it highly cost-effective in the long term. Our results demonstrate the importance of screening for hepatitis B among at-risk groups and then linking screening to treatment. They also illustrate how predictive models can be used to evaluate strategies for improving access to care.
authors.affiliation: University of Pennsylvania School of Medicine, Philadelphia, PA, USA. spost@mail.med.upenn.edu
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Post
authors.forename: Neetu Khurana
authors.initials: NK
authors.lastname: Sodhi
authors.forename: Chia-Hui
authors.initials: CH
authors.lastname: Peng
authors.forename: Kejia
authors.initials: K
authors.lastname: Wan
authors.forename: Henry J
authors.initials: HJ
authors.lastname: Pollack
mesh_terms: D000465:Algorithms; D003191:Comprehensive Health Care; D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D019468:Disease Management; D017048:Health Care Costs; D006297:Health Services Accessibility / Q000191:economics / Q000592:standards*; D006305:Health Status Indicators; D019694:Hepatitis B, Chronic / Q000517:prevention & control* / Q000628:therapy / Q000821:virology; D019458:Insurance Coverage / Q000191:economics; D008390:Markov Chains; D009026:Mortality; D017063:Outcome Assessment, Health Care / Q000191:economics* / Q000706:statistics & numerical data; D011314:Preventive Health Services / Q000191:economics* / Q000706:statistics & numerical data; D011634:Public Health / Q000592:standards*; D011788:Quality of Life; D014481:United States; D019562:Viral Load