You have full text access to this OnlineOpen article

The Impact of Chronic Hepatitis B on Quality of Life: A Multinational Study of Utilities from Infected and Uninfected Persons

  1. Adrian R. Levy PhD1,2,*,
  2. Kris V. Kowdley MD3,
  3. Uchenna Iloeje MD, MPH4,
  4. Eskinder Tafesse PhD4,
  5. Jayanti Mukherjee PhD4,
  6. Robert Gish MD5,
  7. Natalie Bzowej MD5,
  8. Andrew H. Briggs DPhil1,6

Article first published online: 17 DEC 2007

DOI: 10.1111/j.1524-4733.2007.00297.x

Issue

Value in Health

Value in Health

Volume 11, Issue 3, pages 527–538, May/June 2008

Additional Information

How to Cite

Levy, A. R., Kowdley, K. V., Iloeje, U., Tafesse, E., Mukherjee, J., Gish, R., Bzowej, N. and Briggs, A. H. (2008), The Impact of Chronic Hepatitis B on Quality of Life: A Multinational Study of Utilities from Infected and Uninfected Persons. Value in Health, 11: 527–538. doi: 10.1111/j.1524-4733.2007.00297.x

Author Information

  1. 1

    Oxford Outcomes Ltd, Vancouver, BC, Canada;

  2. 2

    University of British Columbia, Vancouver, BC, Canada;

  3. 3

    Digestive Disease Institute, Virginia Mason Medical Center, Seattle, WA, USA;

  4. 4

    Bristol-Myers Squibb Company, Wallingford, CT, USA;

  5. 5

    California Pacific Medical Center, San Francisco, CA, USA;

  6. 6

    Glasgow University, Glasgow, UK

*Adrian R. Levy, Oxford Outcomes Ltd, 450–688 West Hastings Street, Vancouver, BC, Canada V6B 1P1. E-mail: adrian.levy@oxfordoutcomes.com

Publication History

  1. Issue published online: 17 DEC 2007
  2. Article first published online: 17 DEC 2007

SEARCH

SEARCH BY CITATION

ARTICLE TOOLS

View Full Article (HTML) Get PDF (127K)

Keywords:

  • cost-effectiveness;
  • cost-utility international variation;
  • hepatitis B;
  • quality of life;
  • utilities

ABSTRACT

Objectives:  Chronic hepatitis B (CHB) is a condition that results in substantial morbidity and mortality worldwide because of progressive liver damage. Investigators undertaking economic evaluations of new therapeutic agents require estimates of health-related quality of life (HRQOL). Recently, evidence has begun to accumulate that differences in cultural backgrounds have a quantifiable impact on perceptions of health. The objective was to elicit utilities for six health states that occur after infection with the hepatitis B virus from infected and uninfected respondents living in jurisdictions with low and with high CHB endemicity.

Methods:  Standard gamble utilities were elicited from hepatitis patients and uninfected respondents using an interviewer-administered survey in the United States, Canada, United Kingdom, Spain, Hong Kong, and mainland China. Generalized linear models were used to the effect on utilities of current health, age and sex, jurisdiction and, for infected respondents, current disease state.

Results:  The sample included 534 CHB-infected patients and 600 uninfected respondents. CHB and compensated cirrhosis had a moderate impact on HRQOL with utilities ranging from 0.68 to 0.80. Decompensated cirrhosis and hepatocellular carcinoma had a stronger impact with utilities ranging from 0.35 to 0.41. Significant variation was observed between countries, with both types of respondents in mainland China and Hong Kong reporting systematically lower utilities.

Conclusions:  Health states related to CHB infection have substantial reductions in HRQOL and the utilities reported in this study provide valuable information for comparing new treatment options. The observed intercountry differences suggest that economic evaluations may benefit from country-specific utility estimates. The extent that systematic intercountry differences in utilities hold true for other infectious and chronic diseases remains an open question and has considerable implications for the proper conduct and interpretation of economic evaluations.

View Full Article (HTML) Get PDF (127K)