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Shared-care models are highly effective and cost-effective for managing chronic hepatitis B in China: reinterpreting the primary care and specialty divide by Lei Zhang; Hanting Liu; Zhuoru Zou; Shu Su; Jason J. Ong; Fanpu Ji; Fuqiang Cui; Po-lin Chan; Qin Ning; Rui Li; Mingwang Shen; Christopher K. Fairley; Lan Liu; Wai-Kay Seto; William C.W. Wong is a Medicine article available to read on EtoBox.

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## Summary ## Background We evaluate the impact and cost-effectiveness of shared primary-specialty chronic hepatitis B (CHB) care models in China. ## Methods We constructed a decision-tree Markov model to simulate hepatitis B virus (HBV) disease progression in a cohort of 100,000 CHB individuals aged ≥18 years over their lifetime (aged 80). We evaluated the population impacts and cost-effectiveness in three scenarios: (1) __status quo__; (2) shared-care model with HBV testing and routine CHB follow-ups in primary care and antiviral treatment initiation in specialty care; and (3) shared-care model with HBV testing, treatment initiation and routine CHB follow-up in primary care and treatment for predetermined conditions in specialty care. We evaluated from a healthcare provider's perspective with 3% discounting rate and a willingness-to-pay (WTP) threshold of 1-time China's GDP. ## Findings Compared with __status quo__, scenario 2 would result in an incremental cost of US$5.79–132.43m but a net gain of 328–16,993 quality-adjusted life years (QALYs) and prevention of 39–1935 HBV-related deaths over cohort's lifetime. Scenario 2 was not cost-effective with a WTP of 1-time GDP per capit

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Author

Lei Zhang; Hanting Liu; Zhuoru Zou; Shu Su; Jason J. Ong; Fanpu Ji; Fuqiang Cui; Po-lin Chan; Qin Ning; Rui Li; Mingwang Shen; Christopher K. Fairley; Lan Liu; Wai-Kay Seto; William C.W. Wong

Publisher

Elsevier BV

Published

2023

Language

EN

Field

Medicine (Health Sciences)