Cost of chronic hepatitis B infection in South Korea

Goals: To estimate the direct medical costs of chronic hepatitis B (CHB) infection and its liver disease sequelae in South Korea. Background: Korea is a hepatitis B-endernic area with 5.79% to 10.87% of males and 1.51% to 4.44% of females over 20 years of age carrying the virus. It is estimated that 25% of carriers will develop serious hepatitis B virus (HBV)-related complications. While vaccination programs have reduced the prevalence of hepatitis B in people younger than 20 years, significant CHB-related morbidity will continue to occur for the next 15 to 30 years until the benefits of the vaccination programs take effect. Study: Direct medical costs for six CHB-related disease states, including hepatocellular carcinoma and liver transplant, were estimated for the year 2001. Methods: Four data sources were used to gather information: the National Health Insurance Corporation database, patients' medical charts, expert opinion, and patient survey data. Results: In 200 1, the total medical costs of six CHB-related diseases were 250 million Korean Won (KRW) (equivalent to U.S. $208.6 million), based on an exchange rate of KRW 1200 = U.S. $1. Annual treatment costs per patient ranged from KRW 297,392 (U.S. $248) for chronic hepatitis B to KRW 80.6 million (U.S. $67,156) for liver transplant. The cost of treatment rose continuously with liver disease progression. The main cost driver was inpatient hospitalizations (including surgical costs). Conclusion: CHB-related diseases are a significant cost burden to the South Korean healthcare system. In addition to the obvious clinical benefits, the prevention or delay of chronic hepatitis B liver disease progression in South Korea could result in substantial economic benefits to the whole society.