Economic burden of hepatitis C in Egypt: the future impact of highly effective therapies

Abstract

SummaryBackgroundThe prevalence of hepatitis C virus (HCV) infection in Egypt is the highest in the world, yet the total economic burden has not been quantified. Improved understanding of costs and the impact of treatment strategies will provide for better allocation of resources to reduce HCV disease and economic burden.AimA modelling approach was used to quantify the current HCV‐infected population, future disease progression and associated costs in Egypt.MethodsDirect healthcare costs were calculated from a nationally representative hospital and a disability adjusted life year (DALY) template was used with monetary value assigned to lost life years. Three scenarios were considered: (i) Historical treatment scenario: 50% SVR; 65 000 treated annually, (ii) Current treatment scenario: 90% sustained virologic response (SVR); 65 000 treated annually, (iii) Increased treatment scenario: 90% SVR; 325 000 treated annually by 2018.ResultsCumulative DALYs (2015–2030) under Scenario 1 were estimated at 7.88 million and cumulative costs estimated at $89.07 billion. Annual DALYs increased 16% during 2015–2030 while annual costs more than doubled. Scenario 2 reduced cumulative DALYs and costs by 7% and 4%, respectively. Under Scenario 3, total costs declined 73% to $1047 million during 2015–2030. As compared to Scenario 1, cumulative DALYs and costs decreased 37% and 35%, respectively.ConclusionsThis is the first estimate of the total economic burden of HCV in Egypt. Extraordinary measures are necessary to substantially reduce HCV disease and cost burden. With newer therapies, strategies to reduce disease burden are feasible and cost‐effective.

Hepatitis C infection in Egypt: prevalence, impact and management strategies

“…The total burden of chronic HCV infection to the Egyptian economy, including direct costs (HCV-related health care costs) and indirect costs due to disability (the value of lost productivity among chronically infected individuals) and due to loss of life, has been evaluated 30. Direct costs were calculated for HCV-infected individuals who were diagnosed and under care.…”

Epidemiology and viral risk factors for hepatocellular carcinoma in the Eastern Mediterranean countries

“…In 2014, an estimated 125,000 viremic individuals/year were diagnosed with HCV infection. Of these 10% had chronic hepatitis, 30% had compensated cirrhosis, and the majority (60%) were diagnosed with decompensated cirrhosis or HCC [70,71] . The high prevalence of HCC in HCV patients was reported to be associated with decompensated cirrhosis in Egypt [72] .…”

Economic Burden of Hepatitis C Infection

“…75 From Egypt, and annual US$4 billion (2015) has been reported, with only 20% being attributed to direct medical expenses. 76 Finally, an estimate from Australia suggested direct medical expenses of $220 million annually (2013 US dollars), 77 and another estimate from Japan reported up to $3.2 billion per year (2005 US dollars). 78 Furthermore, because more than one-half of the worldwide HCV-infected population lives in South and East Asia, 79 the estimates are likely a fraction of the global economic burden of HCV infection.…”

“…57,70,73,76 Indeed, despite a higher prevalence of HCV in older people in the United States, the vast majority of HCV-infected Americans are still of working age. 52 Outside developed countries with both higher prevalence rates and more new infections, the HCV-infected population is even younger.…”