Cost of treating chronic hepatitis B: Comparison of current treatment guidelines

Table 1 General assumptions of the Markov model of the B positive hepatocellular cancer prevention program

Assumption	How addressed and rationale
Participant recruitment	Target population age ≥ 35 yr, HBsAg +ve for ≥ 6 mo, born in China, Hong Kong, Vietnam
Contact testing and immunisation	Not factored into the model
Seroprevalence in target populations	10.7% for people born in China
	10.5% for people born in Vietnam
	7.7% for people born in Hong Kong (Nguyen et al[16])
Initial testing to confirm chronic hepatitis B	Not factored in the GP consultation calculations
Program participation rates	Base case assumption: 25% of eligible people are enrolled
HCC screening	All participants have AFP and liver US at enrolment
	Participants receiving enhanced surveillance have 6-monthly AFP and US
	Participants receiving treatment also have liver biopsy
Follow up requirements	Routine surveillance arm: 2 GP appointments/yr
	Enhanced HCC surveillance arm: 2 GP appointments/yr
	Interferon treatment: 6 specialist appointments/yr
	Entecavir treatment: 4 specialist appointments/yr
	Patients with HCC: assumed two monthly follow up
Viral load distribution	Based upon Risk Evaluation of Viral Load Elevation and Associated Liver Disease study data (Chen et al[20])
ALT level distribution	Based upon Hong Kong data (Yuen et al[18])
Progression rates through different disease stages	Constant
Treatment protocol	30% receive first line interferon (weekly for 12 mo); 30% seroconvert and receive no further treatment; 70% commence entecavir the following year 70% receive entecavir as first-line treatment; 20% seroconvert in first year and receive no further treatment; 80% continue lifelong entecavir
Patients with liver failure	Receive lifelong entecavir

Lists the general assumptions used in building the model, including treatment protocols and follow up and other relevant elements and data sources. HBsAg: Hepatitis B surface antigen; GP: General practitioner; AFP: α fetoprotein; ALT: Alanine aminotransferase; HCC: Hepatocellular cancer; US: Ultrasound.