title: Chronic hepatitis B monitoring and treatment patterns in five European countries with different access and reimbursement policies.
abstract: BACKGROUND
  In Europe, health-care policies are determined at a national level and differ between countries. This analysis from a prospective, longitudinal, non-interventional study aimed to describe patterns in the clinical monitoring and treatment of chronic hepatitis B (CHB) in five European countries.
  
  
  METHODS
  Country-specific cohorts of adult patients with compensated CHB managed in clinics in Germany, France, Poland, Romania and Turkey were followed for up to 2 years between March 2008 and December 2010.
  
  
  RESULTS
  A total of 1,267 patients were included. Baseline age and gender distribution were similar across countries for patients who were treated (n=567) and untreated (n=700) at baseline. Most treated patients were receiving monotherapy at baseline, most frequently with entecavir or tenofovir in Germany, France and Turkey, and with lamivudine in Poland and Romania. Use of pegylated interferon was more frequent in Poland and Romania than in other countries. In Romania monotherapy with entecavir increased after it became reimbursed in 2008. Hospitalizations during follow-up were more frequent in Romania (1.45 hospital days/patient-year) and Poland (1.81 days/patient-year) than in Turkey, France and Germany (0.00, 0.05 and 0.10 days/patient-year, respectively); clinic visits were more frequent in Poland (3.20 versus 0.30-1.78 visits/patient-year across other countries).
  
  
  CONCLUSIONS
  These results illustrate country-specific patterns in the management of CHB patients across Europe. Observed monitoring patterns, hospitalization rates and other health-care utilization may be related to cost and reimbursement issues; however, further study in individual countries would be required to confirm these (post hoc) observations.
authors.affiliation: Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. sorinarama@gmail.com.
authors.forename: Victoria
authors.initials: V
authors.lastname: Arama
authors.forename: Hakan
authors.initials: H
authors.lastname: Leblebicioglu
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Simon
authors.forename: Jean Pierre
authors.initials: JP
authors.lastname: Zarski
authors.forename: Claus
authors.initials: C
authors.lastname: Niederau
authors.forename: François
authors.initials: F
authors.lastname: Habersetzer
authors.forename: Johannes
authors.initials: J
authors.lastname: Vermehren
authors.forename: Wieslawa
authors.initials: W
authors.lastname: Bludzin
authors.forename: Mariana
authors.initials: M
authors.lastname: Jinga
authors.forename: Sercan
authors.initials: S
authors.lastname: Ulusoy
authors.forename: Isabelle
authors.initials: I
authors.lastname: Klauck
authors.forename: Edith
authors.initials: E
authors.lastname: Morais
authors.forename: Stefan
authors.initials: S
authors.lastname: Bjork
authors.forename: Benedicte
authors.initials: B
authors.lastname: Lescrauwaet
authors.forename: Driss
authors.initials: D
authors.lastname: Kamar
authors.forename: Stefan
authors.initials: S
authors.lastname: Zeuzem
mesh_terms: D000225:Adenine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D004279:DNA, Viral / Q000097:blood / Q000187:drug effects*; D005060:Europe; D005260:Female; D006147:Guanine / Q000031:analogs & derivatives / Q000627:therapeutic use; D006515:Hepatitis B virus / Q000187:drug effects* / Q000502:physiology; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000191:economics* / Q000821:virology; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000706:statistics & numerical data*; D016898:Interferon-alpha / Q000627:therapeutic use; D019259:Lamivudine / Q000627:therapeutic use; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000191:economics / Q000706:statistics & numerical data; D063065:Organophosphonates / Q000627:therapeutic use; D011092:Polyethylene Glycols / Q000627:therapeutic use; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000627:therapeutic use; D000068698:Tenofovir
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D016898:Interferon-alpha; D063065:Organophosphonates; D011994:Recombinant Proteins; D019259:Lamivudine; D011092:Polyethylene Glycols; C413685:entecavir; D006147:Guanine; D000068698:Tenofovir; D000225:Adenine; C100416:peginterferon alfa-2a