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J Dig Dis. 2019 Jun 24. doi: 10.1111/1751-2980.12794. [Epub ahead of print]
A reimbursement program of antiviral therapy reduced liver-related mortality in patients with chronic hepatitis B in Beijing.
Li M1, Kong Y1, Wu S1, Zhou J2, Wu X2, Wang L2, Su J3, Ou X2, You H2, Xie X4, Wei Z3, Jia J2.
Author information
1
Clinical Epidemiology and EBM Unit, National Clinical Research Center for Digestive Disease, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China.
2
Liver Research Center, Beijing Friendship Hospital, Capital Medical University; Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis; National Clinical Research Center for Digestive Disease, Beijing, 100050, China.
3
Statistics Center, Beijing Center for Diseases Prevention and Control, Beijing, 100013, China.
4
National Health and Family Planning Commission of the People's Republic of China, 100044, Beijing, China.
Abstract
OBJECTIVE:
Antiviral hepatitis B therapy has been included in the reimbursement list of medical insurance in Beijing since July 1, 2011. This study aimed to assess the impact of this reimbursement program on liver-related death for patients with Chronic Hepatitis B (CHB).
METHODS:
Profiles of CHB patients discharged between 2008.1 and 2015.12 were retrieved from Hospital Discharge Database of Beijing. Liver-related deaths of these patients occurred between 2008.1 and 2017.12 were retrieved by linking to Death Certification Database. Liver-related mortality (dividing the number of death cases by their observed person-years) before and after launching this reimbursement program were calculated and compared. Poisson regression was performed to assess the strength of association (risk ratio, RR) between this reimbursement program and liver-related mortality.
RESULTS:
Information of 35,943 discharged patients was retrieved, consisting of 17,114 non-cirrhotic and 18,829 compensated cirrhotic CHB patients. There were 3,832 liver-related deaths during 190,695 observed person-years. After launching this reimbursement program, liver-related mortality per 100 person-years dropped from 0.38% to 0.16% for non-cirrhotic CHB patients, and it also declined from 4.03% to 3.39% for compensated cirrhotic CHB patients. This reimbursement program was associated with a lower risk of developing liver-related death for non-cirrhotic (RR=0.40, 95%CI: 0.30-0.52) and compensated cirrhotic CHB patients (RR=0.84, 95%CI: 0.78-0.89).
CONCLUSIONS:
Coverage of antiviral therapy by basic medical insurance reduced the risk of developing liver-related death for non-cirrhotic and compensated cirrhotic CHB patients. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.
KEYWORDS:
Chronic hepatitis B; Liver-related death; Reimbursement
PMID:
31231938
DOI:
10.1111/1751-2980.12794
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