A global investment case for hepatitis B elimination: a modelling study

Authors:

• Seaman, Christopher P
• Luong, Phillip
• Xiao, Yinzong
• Abeysuriya, Romesh
• Howell, Jess
• Hellard, Margaret
• Scott, Nick

Details:

The Lancet Gastroenterology & Hepatology, Volume 8, Issue 10, 2023-10-31

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Hepatitis B is estimated to cause 500 000–900 000 deaths globally each year. WHO has targets for elimination by 2030; however, progress has stalled due to multiple barriers, notably a paucity of global funding and insufficient evidence on the economic burden of disease. Using a dynamic mathematical model of hepatitis B transmission, disease progression, and mortality in the six WHO regions, we estimate the costs and benefits of reaching 90% vaccination, 90% diagnosis, and 80% treatment coverage by either 2030 (as targeted), 2040, or 2050. Without increased intervention coverage, hepatitis B mortality was estimated to cost US$784·35 billion (95% Crl 731·63–798·33 billion) globally in lost productivity over 2022–50. Achieving targets by 2030 averted 25·64 million infections (95% Crl 17·39–34·55 million) and 8·63 million hepatitis B-attributable deaths (95% Crl 7·12–9·74 million) over 2022–50. This achievement incurred an incremental cost of $2934·55 (95% Crl 2778·55–3173·52) per disability-adjusted life year averted by 2050 under a health systems perspective, and was cost-saving with a net economic benefit of $99·03 billion (95% Crl 78·66–108·96 billion) by 2050 from a societal perspective. Delayed achievement of intervention coverage targets had reduced health and economic benefits. These findings highlight that hepatitis B is an underappreciated cause of economic burden and show investment toward elimination will probably yield substantial returns.