Nayagam, ShevanthiChan, PolinZhao, KunSicuri, ElisaWang, XiaochunJia, JidongWei, LaiWalsh, NickRodewald, Lance E.Zhang, GuominAiling, WangZhang, LanChang, Joo H.Hou, WeiWeiQiu, YingpengSui, BinyanXiao, YueZhuang, HuiThursz, M.R.Scano, FabioLow-Beer, DanielSchwartländer, BernhardWang, YuHallett, Timothy B.2020-05-272020-05-272020-04-071058-4838https://hdl.handle.net/2445/162677BACKGROUND content: In 2016, the first global viral hepatitis elimination targets were endorsed. An estimated one-third of the world's population of individuals with chronic hepatitis B virus (HBV) infection live in China and liver cancer is the sixth leading cause of mortality, but coverage of first-line antiviral treatment was low. In 2015, China was one of the first countries to initiate a consultative process for a renewed approach to viral hepatitis. We present the investment case for the scale-up of a comprehensive package of HBV interventions. METHODS content: A dynamic simulation model of HBV was developed and used to simulate the Chinese HBV epidemic. We evaluated the impact, costs, and return on investment of a comprehensive package of prevention and treatment interventions from a societal perspective, incorporating costs of management of end-stage liver disease and lost productivity costs. RESULTS content: Despite the successes of historical vaccination scale-up since 1992, there will be a projected 60 million people still living with HBV in 2030 and 10 million HBV-related deaths, including 5.7 million HBV-related cancer deaths between 2015 and 2030. This could be reduced by 2.1 million by highly active case-finding and optimal antiviral treatment regimens. The package of interventions is likely to have a positive return on investment to society of US$1.57 per US dollar invested. CONCLUSIONS content: Increases in HBV-related deaths for the next few decades pose a major public health threat in China. Active case-finding and access to optimal antiviral treatment are required to mitigate this risk. This investment case approach provides a real-world example of how applied modeling can support national dialog and inform policy planning.10 p.application/pdfengcc-by (c) Nayagam et al. , 2020http://creativecommons.org/licenses/by/3.0/es/Hepatitis BXinaHepatitis BChinainfo:eu-repo/semantics/article2020-05-22info:eu-repo/semantics/openAccess32255486