Supplementary Material for: Characteristics and Healthcare Costs in the Aging Hepatitis B Population of Japan: A Nationwide Real-World Analysis

<b><i>Introduction:</i></b> Advancing age, comorbidity, and financial burden have been observed in chronic hepatitis B (CHB) patients globally. As Japan is leading the world in aging demographics, similar real-world data are urgently needed for its CHB population to inform all stakeholders. <b><i>Methods:</i></b> This cross-sectional study characterized the demographics, comorbidities, and healthcare costs of a large Japanese real-world adult (≥18 years) CHB patient (ICD-10: B18.1) population from the Medical Data Vision database from January 01, 2012, to December 31, 2016. Comorbidities were identified by ICD-10 codes, and the annual point prevalence and Charlson Comorbidity Index (CCI) score were calculated. Annual mean and median all-cause healthcare utilization and costs per patient were calculated. Comparison tests were conducted for CCI scores, prevalence of comorbidities, and healthcare resource utilization and costs. <b><i>Results:</i></b> We identified 11,125 CHB patients. Between 2012 and 2016, the mean age increased from 62.0 to 65.2 years, and the percentage of those aged ≥65 years increased from 45.6% to 60.7%. The prevalence of cirrhosis remained similar (5.8% in 2012 and 5.6% in 2016, <i>p</i> = 0.69) while hepatocellular carcinoma decreased from 6.3% to 4.5% (<i>p</i> &lt; 0.01). The prevalence of nonliver comorbidities increased (40.9–52.0% for cancer [<i>p</i> &lt; 0.01], 12.1–17.7% for osteoporosis [<i>p</i> &lt; 0.01], and 10.7–15.0% for renal impairment [<i>p</i> &lt; 0.01]). Healthcare resource utilization and costs also increased, with a 119.3% increase in median total healthcare costs from JPY 229,143 in 2012 to 502,467 in 2016 (<i>p</i> &lt; 0.01). <b><i>Conclusions:</i></b> The CHB population of Japan is predominantly elderly and carry a high nonliver comorbidity burden, while incurring increasing healthcare costs.

**引言：** 全球范围内的慢性乙型肝炎（chronic hepatitis B, CHB）患者群体均呈现出年龄增长、合并症增多与经济负担加重的态势。鉴于日本是全球人口老龄化程度最高的国家，其慢性乙型肝炎患者群体亟需同类真实世界研究数据，以为各方利益相关者的决策提供依据。**方法：** 本项横断面研究以2012年1月1日至2016年12月31日期间收录于Medical Data Vision数据库的日本大型成年（≥18岁）慢性乙型肝炎患者（ICD-10编码：B18.1）队列作为研究对象，对其人口学特征、合并症情况及医疗成本进行了特征分析。研究通过ICD-10编码识别合并症，并计算了年度时点患病率与查尔森合并症指数（Charlson Comorbidity Index, CCI）评分；同时核算了每位患者每年的全因医疗服务使用率及医疗成本的均值与中位数，并针对CCI评分、合并症患病率、医疗资源使用率及医疗成本开展了比较性检验。**结果：** 本研究共纳入11125例慢性乙型肝炎患者。2012年至2016年间，患者平均年龄从62.0岁升至65.2岁，≥65岁人群占比从45.6%提升至60.7%。肝硬化患病率基本保持稳定（2012年为5.8%，2016年为5.6%，*p* = 0.69），而肝细胞癌患病率则从6.3%降至4.5%（*p* < 0.01）。非肝脏合并症患病率均有所上升：癌症患病率从40.9%升至52.0%（*p* < 0.01），骨质疏松症患病率从12.1%升至17.7%（*p* < 0.01），肾功能损害患病率从10.7%升至15.0%（*p* < 0.01）。医疗资源使用率与医疗成本亦呈上升态势，患者医疗总成本中位数从2012年的229143 JPY升至2016年的502467 JPY，增幅达119.3%（*p* < 0.01）。**结论：** 日本慢性乙型肝炎患者群体以老年人为主，合并非肝脏疾病的负担较重，且医疗成本持续攀升。