Costs and absence of HCV-infected employees by disease stage

Baran, Robert W.; Samp, Jennifer C.; Walker, David; Smeeding, James E.; Young, J.; Kleinman, Nathan L.; Brook, Richard A.

doi:10.3111/13696998.2015.1045423

Cited by 19 publications

(24 citation statements)

References 16 publications

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“…Furthermore, the mean short‐term disability days and associated costs were also greater for the noncirrhotic with HCV (days = 2.03, cost = $299), decompensated cirrhotics with HCV (days = 6.20, cost = $763) and HCV liver transplants (days = 21.98, cost = $2537) as compared to non‐HCV controls (days = 1.19, cost=$155). Finally, costs associated with sick leaves were also greater for noncirrhotic ($373) and decompensated cirrhotics ($460) compared to the non‐HCV controls ($327) .…”

Section: Introductionmentioning

confidence: 98%

Association of work productivity with clinical and patient‐reported factors in patients infected with hepatitis C virus

Younossi

Stepanova

Henry

et al. 2016

Journal of Viral Hepatitis

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Patients with HCV infection have reduced work productivity (WP), in terms of both presenteeism (impairment in work productivity while working) and absenteeism (productivity loss due to absence from work). The aim of this study was to identify clinical and patient-reported factors that are predictive of WP in HCV-infected patients. HCV-infected patients enrolled in clinical trials completed 3 PRO questionnaires (CLDQ-HCV, SF-36 and FACIT-F) and one work productivity (WPAI:SHP) questionnaire. In employed subjects, work productivity and its absenteeism and presenteeism components were calculated using WPAI:SHP instrument. Of 4121 HCV-infected patients with work productivity data, 2480 (60.2%) reported to be employed, and of those, 2190 had completed all PRO questionnaires before treatment initiation. Of the study cohort, 519/2190 (23.7%) had severe work impairment. In multiple linear regression analysis, work productivity was predicted by lower scores in activity/energy domain of CLDQ-HCV, physical well-being domain of FACIT-F, worry domain of CLDQ-HCV and role physical domain of SF-36 (all P < 0.0005). Furthermore, presenteeism was independently predicted by the activity/energy of CLDQ-HCV, physical well-being of FACIT-F, worry domain of CLDQ-HCV, role physical scale of SF-36 and fatigue scale of FACIT-F (P < 0.002). Finally, absenteeism was independently predicted by physical well-being scale of FACIT-F and role physical scale of SF-36 (all P < 0.002). Clinically, work productivity impairment was predicted by the presence of cirrhosis, anxiety, depression and clinically overt fatigue (P < 0.01). Thus, the most important drivers of WP in HCV are impairment of physical aspects of PROs and clinical history of depression, anxiety, fatigue and cirrhosis.

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Section: Introductionmentioning

confidence: 98%

Association of work productivity with clinical and patient‐reported factors in patients infected with hepatitis C virus

Younossi

Stepanova

Henry

et al. 2016

Journal of Viral Hepatitis

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“…For Medicare patients, we assign annual medical management costs based on the calculation of overall medical costs attributable to HCV by stage using a two‐part log‐link “tpm” module in STATA on 2009 SEER/5% Medicare claims data, representing 407,786 Medicare beneficiaries 3, 15. Medical management costs for non‐Medicare‐insured patients are based on published estimates of attributable costs calculated for private payers 16. By assumption, we apply these costs for uninsured patients with cirrhosis or ESLD but do not apply medical management costs for uninsured patients with chronic infection.…”

Section: Methodsmentioning

confidence: 99%

Potential epidemiologic, economic, and budgetary impacts of current rates of hepatitis C treatment in medicare and non‐medicare populations

Wittenborn

Brady

Dougherty

et al. 2017

Hepatology Communications

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We forecast the health and budgetary impact of hepatitis C (HCV) treatment on the Medicare program based on currently observed rates of treatment among Medicare and non‐Medicare patients and identify the impact of higher rates of treatment among non‐Medicare populations. We developed a computer microsimulation model to conduct an epidemiologic forecast, a budgetary impact analysis, and a cost‐effectiveness analysis of the treatment of HCV based on three scenarios: 1) no treatment, 2) continuation of current‐treatment rates, and 3) treatment rates among non‐Medicare patients increased to match that of Medicare patients. The simulated population is based on National Health and Nutrition Examination Survey data. HCV progression rates and costs were calculated in Surveillance, Epidemiology, and End Results Program Medicare 5% claims data from the Chronic Hepatitis Cohort Study and published literature. We estimate that 13.6% of patients with HCV in the United States are enrolled in Medicare, but 75% will enter Medicare in the next 20 years. Medicare patients were over 5 times as likely to be treated in 2014‐2015 as other patients. Medicare paid over $9 billion in treatment costs in both 2015 and 2016 and will total $28.4 billion from 2017‐2026. Increasing treatment rates among non‐Medicare patients would lead to 234,000 more patients being treated, reduce HCV mortality by 19%, and decrease Medicare costs by $18.6 billion from 2017‐2026. We find that treatment remains cost‐effective under most assumptions, costing $31,718 per quality adjusted life year gained. Conclusion: Medicare treats a disproportionately large share of HCV patients. Continued low rates of treatment among non‐Medicare HCV patients will result in both reduced and deferred treatment, shifting future treatment costs to Medicare while increasing overall medical management costs, morbidity, and mortality. (Hepatology Communications 2017;1:99‐109)

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“…HCV infection is also associated with increased rates of presenteeism [70,84,115,116]. The indirect economic burden of WP loss in the U.S. has been estimated to be approximately 7.1 billion USD per year while the WP loss from 5 major European countries (France, Germany, Spain, Italy and United Kingdom) has been estimated to be 2.6 billion Euros per year [116,117]. Furthermore, WP loss from Asia (Hong Kong, South Korea, Singapore and Taiwan) has been estimated to be over half a billion dollars per year with treatment resulting in a gain of USD 208.9 million per year [118].…”

Section: Economic Burden Of Hcv-related Liver Diseasementioning

confidence: 99%

“…HCV appears to affect absenteeism from work leading to substantial economic burden to employers. HCV infection is also associated with increased rates of presenteeism [70,84,115,116]. The indirect economic burden of WP loss in the U.S. has been estimated to be approximately 7.1 billion USD per year while the WP loss from 5 major European countries (France, Germany, Spain, Italy and United Kingdom) has been estimated to be 2.6 billion Euros per year [116,117].…”

Section: Economic Burden Of Hcv-related Liver Diseasementioning

confidence: 99%

Hepatitis C infection: A multi-faceted systemic disease with clinical, patient reported and economic consequences

Younossi

Birerdinc

Henry

2016

Journal of Hepatology

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Hepatitis C virus infection (HCV) affects approximately 170-200 million individuals globally. HCV is one of the primary causes of hepatocellular carcinoma (HCC) and cirrhosis and has been identified as the leading indication for liver transplantation in most Western countries. Because HCV is a systemic disease with hepatic, extrahepatic, economic and patient reported consequences, it is important for healthcare practitioners to understand the comprehensive and multi-faceted picture of this disease. In this context, it is important to fully appreciate the impact of HCV on the individual patient and the society. With the recent advent of the new generation of direct antiviral agents, the long standing goal of eradicating HCV in most infected patients has been accomplished. Therefore, now more than ever, it is critical to assess the total benefits of sustained virological response in a comprehensive manner. This should not be limited to the clinical benefits of HCV cure, but also to account for the improvement of patient reported health and economic outcomes of HCV cure. It is only through this comprehensive approach to HCV and its treatment that we will understand the full impact of this disease and the tremendous gains that have been achieved with the new antiviral regimens.

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Costs and absence of HCV-infected employees by disease stage

Cited by 19 publications

References 16 publications

Association of work productivity with clinical and patient‐reported factors in patients infected with hepatitis C virus

Association of work productivity with clinical and patient‐reported factors in patients infected with hepatitis C virus

Potential epidemiologic, economic, and budgetary impacts of current rates of hepatitis C treatment in medicare and non‐medicare populations

Hepatitis C infection: A multi-faceted systemic disease with clinical, patient reported and economic consequences

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