RESUMO
BACKGROUND: Finland is among the countries with low hepatitis B endemicity. We evaluate the hepatitis B-related disease and economic burden needed for evidence-based immunisation policy decision-making. METHODS: Hepatitis B-related cases in 2004-2012 were retrieved from population-based nationwide registers. We evaluated the incidence, health care resource use, health care costs, and life years lost due to hepatitis B-related outcomes. An episode of care was constructed from each individual's hepatitis B-related events retrieved from individually linkable registers. RESULTS: The mean health care costs per an acute hepatitis B case were 450 (SD 240), 2030 (SD 350), and 5400 (SD 3370) in those aged 0-14, 15-64, and ≥65 years, respectively. For chronic infection, the mean cost per case among Finnish-born individuals was 990 and among foreign-born 1360. The costs per case of liver cirrhosis were 15,350 and liver cancer 19,080. In addition, the annual antiviral medication costs per case receiving antiviral medication were 4710 to 5530. Annually <10% of the chronic and approximately 20% of liver cirrhosis cases received antiviral medication. We identified annually 21 acute, 264 chronic, three liver cirrhosis, and four liver cancer cases and 63.7 life years lost due to hepatitis B per 5.3 million inhabitants. The total annual health care costs were 1.2 million of which 60% were antiviral medication costs and 86% accounted for chronic hepatitis B. CONCLUSIONS: When planning prevention of hepatitis B infection, it is pivotal to notice that the overall disease and economic burden due to hepatitis B is mostly due to chronic infection.