Journal of Gastroenterology and Hepatology (2001) 16, 301–308 those who have been infected vertically have a poorer prognosis; these patients not only have a greater chance of becoming chronically infected with the virus (90% of vertical transmission results in chronic infection), but also have a decreased likelihood of overcoming the infection by seroconversion. 1 Indeed, South Korean patients with chronic HBV infection have a 48% risk of INTRODUCTION Hepatitis B (HBV) infection is passed either perinatally from mother to child or horizontally via sexual trans- mission, intravenous drug use, or intrafamished domes- tic transmission. In South Korea, the disease is endemic and the main route of infection is vertical. Generally, HEPATITIS B AND C VIRUS INFECTION Economic evaluation of the societal costs of hepatitis B in South Korea BONG MIN YANG,* SEUNG WOON PAIK, † OH SERK HAHN, ‡ DEOK HEE YI, § MOON SUK CHOI † AND SARAH PAYNE ¶ *School of Public Health, Seoul National University, South Korea, † Division of Gastroenterology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea, ‡ Drug Price Management Council, Health Insurance Review Agency, Seoul, South Korea, § School of Public Health, University of North Carolina, Chapel Hill, USA and ¶ Glaxo Wellcome Research and Development, Middlesex, UK Abstract Background and Aims: Hepatitis B (HBV) infection remains a major public health problem in South Korea, and accounts for considerable morbidity and mortality. At present, very little is known about the cost of HBV to the South Korean health-care system and society. The present study was therefore conducted to estimate the total annual cost of HBV infection in South Korea for a given year (1997). Methods: The study was conducted from the South Korean societal perspective, taking into account the direct and indirect costs of HBV vaccination programs (prevention costs), and those related to the treatment of acute and chronic hepatitis, cirrhosis and liver cancer (disease costs). Several assumptions were made in arriving to actual cost estimates. Results: The total societal cost of HBV in 1997 was 1078.3 billion Won ($US 959.7 million), 142.3 billion Won or 13.2% being attributable to prevention costs and 225.4 billion Won or 20.9% being attributable to indirect costs of HBV-related diseases. The total cost (direct plus indirect) associated with HBV-related diseases to the South Korean society was 936.1 billion Won ($US833.1 million), of which 45.3% was attributable to cirrhosis-related costs. In terms of disease-related direct costs alone (710.5 billion Won or $US632.3 million), the estimated annual spending per patient was 1.37 million Won ($US1219). The direct costs of the HBV disease (prevention and disease treatment, amounting to 782.2 billion Won or $US696.2 million) is equivalent to 3.2% of the national health-care expendi- ture for 1997. Conclusions: This study confirms that HBV is a significant cost burden to the South Korean society, and in the absence of an effective cure reinforces the importance of continued disease prevention via vaccination. © 2001 Blackwell Science Asia Pty Ltd Key words: cost-of-illness analysis, hepatitis B, vaccination. Correspondence: Prof. BM Yang, School of Public Health, Seoul National University, 28 Yun-kun-dong, Chongro-ku, Seoul 110-799, South Korea. Email: bmyang@snu.ac.kr Accepted for publication 23 November 2000.