Economic Burden of Hepatitis B at Different Stages of the Disease: A Systematic Review Study.

Background: Viral hepatitis is the most prevalent liver disease in the world. This disease imposes a great economic burden on families and the health system. This study was conducted to investigate the economic burden of hepatitis B at different ages of the disease using a systematic review method.

Methods: Using the systematic review method, the researcher extracted articles related to the economic burden of hepatitis B at different stages of the disease using domestic and international databases including SID, MEDLINE/PubMed, Embase, Web of Science, NHS Economic Evaluation Database (EED), EconLit, and Google Scholar before April 2020 and used the PICOTS framework to select the inclusion criteria. Quality assessment of methodology of the studies was evaluated using Drummond's checklist.

Results: After searching for articles based on inclusion and exclusion criteria, 18 articles were included in the final analysis. The findings showed that the highest mean direct medical costs were $ 2748 for chronic hepatitis B, $ 18903 for compensated cirrhosis, $35668 for decompensated cirrhosis, and $93228 for liver cancer. In all of the studies, the highest mean direct medical costs were those of liver transplantation ($ 355000).

Conclusions: The treatment costs of diseases related to chronic hepatitis B increase significantly at different stages the disease progression. Although vaccination actions can reduce the disease, we require more investment in the health system infrastructure to provide patients' access to hepatitis drugs and reduce their direct payments.