Direct medical costs associated with the extrahepatic manifestations of hepatitis C virus infection in France

Cacoub, P.; Vautier, Mathieu; Desbois, Anne Claire; Saadoun, David; Younossi, Zobair M.

doi:10.1111/apt.14382

Cited by 15 publications

(23 citation statements)

References 27 publications

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“…Another recent study from France estimated the same burden of EHMs of HCV to be V256 million per year (2015). 82 It is important to note that the prevalence of EHMs in this study were high in comparison with other similar reports (eg, the prevalence of mixed cryoglobulinemia in HCV was 51% with the rate of hospitalization for it of 26%, which well exceeds other similar estimates 81,83,84 ) and, thus, the reported national cost of the EHMs substantially exceeded the cost of all HCV-related inpatient hospital stays in the country, including those for liver transplantation. 85 A number of reports on the prevalence rates of EHMs of HCV in other countries suggested notably high rates of up to 75%, 86-89 but so far have not been accompanied by the cost of illness analyses.…”

Section: Economic Burden Of the Extrahepatic Manifestations Of Hepaticontrasting

confidence: 47%

Economic Burden of Hepatitis C Infection

Stepanova

Younossi

2017

Clinics in Liver Disease

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Section: Economic Burden Of the Extrahepatic Manifestations Of Hepaticontrasting

confidence: 47%

Economic Burden of Hepatitis C Infection

Stepanova

Younossi

2017

Clinics in Liver Disease

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“…Our study is one of only a few to simulate the impact of DAA treatment on the economic burden of EHMs . The EHMs with the greatest contributions to estimated cost savings upon achievement of SVR were T2DM and mixed cryoglobulinemia, given their high rate of excess prevalence in HCV patients and substantial per‐patient costs.…”

Section: Discussionmentioning

confidence: 99%

“…A previously validated economic analysis was adapted to the German, Spanish, Italian, and UK perspectives and used to estimate the annual direct medical cost associated with EHMs of HCV. Estimates from the French perspective were taken from our previously published analyses …”

Section: Methodsmentioning

confidence: 99%

“…A recent meta‐analysis has further quantified the excess prevalence of specific EHMs, including type 2 diabetes, B‐cell lymphoma and Sjögren's syndrome, in HCV patients . Prior work has shown that the annual economic burden of EHMs of HCV is substantial in the USA and France, at $1.5 billion (bn) and €256 million (m), respectively . However, the direct medical costs associated with HCV‐related EHMs in other European countries remain unknown.…”

Section: Introductionmentioning

confidence: 99%

“…Clinical guidelines in Europe, therefore, recommend that HCV patients with clinically significant EHMs be prioritized for DAA treatment . A recent study from France has estimated that DAA treatment may reduce the economic burden of EHMs by up to 13% . However, the impact of DAA treatment on the economic burden of EHMs in other European countries remains unknown.…”

Section: Introductionmentioning

confidence: 99%

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Direct medical costs associated with the extrahepatic manifestations of hepatitis C infection in Europe

Cacoub

Buggisch

Carrión

et al. 2018

Journal of Viral Hepatitis

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Hepatitis C virus (HCV) infection is a systemic disease associated with both hepatic and extrahepatic manifestations. The burden associated with the hepatic manifestation of HCV infection has been well documented in Europe, although that of HCV extrahepatic manifestations remains unknown. In this study, we estimated the annual direct medical costs associated with HCV extrahepatic manifestations in five European countries. A previously validated economic model was used to estimate the annual direct medical cost associated with HCV extrahepatic manifestations. Global excess prevalence of extrahepatic manifestations in HCV patients relative to that in non-HCV patients was obtained from a recent meta-analysis. Per-patient per-year inpatient, outpatient and medication costs to treat each extrahepatic manifestation were from the literature, national databases or expert opinion if unavailable otherwise. All costs were adjusted to 2016 euros (€). The overall direct medical costs associated with HCV extrahepatic manifestations were calculated by multiplying the total per-patient per-year costs of each by the respective excess prevalence rates and then by the size of the HCV-infected population in each country. Treatment impact with direct-acting antivirals (DAAs) was explored using HCV extrahepatic manifestations excess prevalence rates among cured patients compared to untreated HCV patients, as sourced from a meta-analysis. The total annual direct medical cost associated with HCV extrahepatic manifestations was estimated to be 2.17 billion euro (€), with a per-HCV-patient cost ranging from €899 to €1647 annually. DAA treatment was projected to result in cost savings of €316 million per year. We find that the annual economic burden of extrahepatic manifestations is significant and may be partly mitigated by treatment with DAAs.

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Impact of All‐Oral Direct‐Acting Antivirals on Clinical and Economic Outcomes in Patients With Chronic Hepatitis C in the United States

et al. 2019

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Approved treatment for hepatitis C virus (HCV) with all-oral direct acting antivirals (DAA) therapy is now entering into its fourth year; however, little has been reported on the real world clinical [decompensated cirrhosis (DCC) and hepatocellular carcinoma (HCC)] and economic outcomes. A retrospective cohort analysis of the Truven Health MarketScan Database (2012 - 2016) was conducted. In a cohort of 26,105 newly diagnosed HCV patients, 30% received all-oral DAA therapy (DAA group) and 70% were not treated (untreated group). Multivariate Cox proportional hazards models were used to compare the risk of developing HCC and DCC, stratified by cirrhosis status. Among cirrhotic patients (n=2,157), DAA therapy was associated with a 72% and a 62% lower incidence of HCC (hazard ratio (HR): 0.28; 95% confidence interval (CI):0.15-0.52) and DCC (HR: 0.38; 95% CI: 0.26-0.56). Similarly, DAA therapy was associated with a 57% and a 58% lower incidence of HCC (HR: 0.43; 95% CI:0.26-0.71) and DCC (HR: 0.42; 95% CI: 0.30-0.58) in non-cirrhotic HCV patients (n=23,948). A propensity-score matched cohort of 8,064 HCV-infected patients who had at least a 12-month follow-up after HCV treatment was included for economic analysis. For cirrhotic patients in the DAA group, the mean adjusted liver-related costs ($1,749 vs $4,575; P<0.001) and all-cause medical costs ($19,300 vs $33,039; P<0.001) were significantly lower compared to those in the untreated group. The mean adjusted costs were not statistically different between the two groups among non-cirrhotic patients. Conclusions: In the short term, all-oral DAA treatment for HCV infection was associated with a decreased risk of developing HCC and DCC resulting in decreased healthcare costs, especially in cirrhotic patients. A longitudinal study is necessary to confirm our findings.

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Direct medical costs associated with the extrahepatic manifestations of hepatitis C virus infection in France

Cited by 15 publications

References 27 publications

Economic Burden of Hepatitis C Infection

Economic Burden of Hepatitis C Infection

Direct medical costs associated with the extrahepatic manifestations of hepatitis C infection in Europe

Impact of All‐Oral Direct‐Acting Antivirals on Clinical and Economic Outcomes in Patients With Chronic Hepatitis C in the United States

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