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Hepatitis C in the era of direct-acting antivirals: real-world costs of untreated chronic hepatitis C; a cross-sectional study
Kieran, Jennifer Ann; Norris, Suzanne; O'Leary, Aisling; Walsh, Cathal Dominic; Merriman, Raphael; Houlihan, D.; McCormick, Aiden; McKiernan, Susan; Bergin, Colm; Barry, Michael
Background: Recent advances in Hepatitis C therapeutics offer the possibility of cure but will be expensive. The cost of treatment may be partially offset by the avoidance of advanced liver disease. We performed a micro-costing study of the ambulatory healthcare utilisation of patients with Hepatitis C supplemented with inpatient diagnosis related group costs.Methods: The staff utilisation costs associated with a Hepatitis C ambulatory visit were measured and combined with the costs of investigations to establish a mean cost per consultation. An annualised estimate of cost was produced by multiplying this by the number of consultations accessed, stratified by degree of liver impairment. Inpatient costs were established by identifying the number of inpatient episodes and multiplying by Irish diagnosis related group costs. Non-parametric bootstrapping was performed to derive mean and 95% CI values.Results: Two hundred and twenty-five patients were identified. The cost of an outpatient medical review was (sic) 136 ((sic)3.60 SD). The cost of a Hepatitis C nursing review was (sic) 128 ((sic)7.30 SD). The annual mean costs of care were as follows (95% CI): Mild (sic) 398 ((sic) 336, (sic) 482), Moderate (sic) 417((sic) 335, (sic) 503), Compensated cirrhosis (sic) 1790 ((sic) 990, (sic) 3164), Decompensated cirrhosis (sic) 8302 ((sic) 3945, (sic) 14,637), Transplantation Year 1 (sic) 137,176 ((sic) 136,024, (sic) 138,306), Transplantation after Year 1 (sic) 5337 ((sic) 4942, (sic) 5799), Hepatocellular carcinoma (sic)21,992 ((sic)15,222, (sic)29,467), Sustained virological response (sic)44 ((sic)16, (sic)73).Conclusions: The direct medical cost associated with Hepatitis C care in Ireland is substantial and increases exponentially with progression of liver disease. The follow-up costs of patients with a sustained virological response in this cohort were low in comparison to patients with chronic infection. PUBLISHED peer-reviewed
Keyword(s): Ireland; health economics; direct medical cost; hepatitis C
Publication Date:
2015
Type: Journal article
Peer-Reviewed: Yes
Language(s): English
Institution: University of Limerick
Citation(s): BMC Infectious Diseases;15:471
Publisher(s): BioMed Central
First Indexed: 2016-02-28 05:34:58 Last Updated: 2018-07-08 06:35:07