Yang Bong-Min, Kim Cheol-Hwan, Kim Ji-Yun
School of Public Health, Seoul National University, Seoul 110-799, South Korea.
J Clin Gastroenterol. 2004 Nov-Dec;38(10 Suppl 3):S153-7. doi: 10.1097/00004836-200411003-00007.
To estimate the direct medical costs of chronic hepatitis B (CHB) infection and its liver disease sequelae in South Korea.
Korea is a hepatitis B-endemic 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.
Direct medical costs for six CHB-related disease states, including hepatocellular carcinoma and liver transplant, were estimated for the year 2001.
Four data sources were used to gather information: the National Health Insurance Corporation database, patients' medical charts, expert opinion, and patient survey data.
In 2001, the total medical costs of six CHB-related diseases were 250 million Korean Won (KRW) (equivalent to U.S. 208.6 million dollars), based on an exchange rate of KRW 1200 = US 1 dollar. Annual treatment costs per patient ranged from KRW297,392 (US 248 dollars) for chronic hepatitis B to KRW 80.6 million (U.S. 67,156 dollars) for liver transplant. The cost of treatment rose continuously with liver disease progression. The main cost driver was inpatient hospitalizations (including surgical costs).
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.
估算韩国慢性乙型肝炎(CHB)感染及其肝病后遗症的直接医疗费用。
韩国是乙型肝炎流行地区,20岁以上男性携带该病毒的比例为5.79%至10.87%,女性为1.51%至4.44%。据估计,25%的携带者会出现严重的乙型肝炎病毒(HBV)相关并发症。虽然疫苗接种计划降低了20岁以下人群中乙型肝炎的患病率,但在疫苗接种计划的益处生效之前,未来15至30年仍将持续出现与CHB相关的显著发病率。
估算了2001年六种与CHB相关疾病状态(包括肝细胞癌和肝移植)的直接医疗费用。
使用了四个数据源来收集信息:国民健康保险公团数据库、患者病历、专家意见和患者调查数据。
2001年,根据1200韩元 = 1美元的汇率,六种与CHB相关疾病的总医疗费用为2.5亿韩元(相当于2.086亿美元)。每位患者的年度治疗费用从慢性乙型肝炎的297,392韩元(248美元)到肝移植的8060万韩元(67,156美元)不等。治疗费用随着肝病进展持续上升。主要成本驱动因素是住院治疗(包括手术费用)。
与CHB相关的疾病给韩国医疗保健系统带来了巨大的成本负担。除了明显的临床益处外,在韩国预防或延缓慢性乙型肝炎肝病进展可为整个社会带来巨大的经济效益。