Feasibility and cost-effectiveness of a hospital-based hepatitis B management model in China: the 'Hot Wave Project' experience.

BACKGROUND

Chronic hepatitis B virus (HBV) infection remains a major burden. The "Hot Wave Project," a hospital-wide initiative launched in 2022, aims to enhance HBV care by integrating patient education with systematic screening, referral, diagnosis, treatment, and follow-up.

METHODS

We conducted a comparative analysis of hospital-wide HBV care metrics between 2021 (preintervention) and 2024 (postintervention). An interrupted time series (ITS) analysis was conducted on monthly data to evaluate the causal impact of the intervention. A decision-analytic Markov model was used to simulate the cost-effectiveness and epidemiological impact of the project on a hypothetical cohort of one million patients.

RESULTS

From 2021 to 2024, the HBsAg screening rate hospital-wide increased from 11.75% to 15.25%. Referrals of HBsAg-positive patients from nonhepatology departments surged from 9.26% to 17.87% (p < 0.0001), and the overall antiviral treatment rate rose from 71.00% to 80.25%. ITS analysis confirmed that the intervention caused significant immediate increases in screening and referral rates and a sustained acceleration in treatment uptake. Regular follow-up rates increased modestly from 59.96% to 61.5%. The model projected that the 2024 intervention levels would avert 17.4 HBV-related deaths per 100,000 person-years, yielding an incremental cost-effectiveness ratio (ICER) of $5688 per quality-adjusted life year (QALY) gained.

CONCLUSION

The "Hot Wave Project" is a cost-effective and scalable hospital-based model that significantly improves the HBV care continuum. By enhancing interdisciplinary coordination, this approach offers an adaptable framework to help China advance toward its viral hepatitis elimination targets.