Health care costs associated with chronic hepatitis C virus infection in Ontario, Canada: a retrospective cohort study

Abstract

L ike other developed countries, Canada agreed to meet the World Health Organization targets to reduce new cases of hepatitis C virus (HCV) infection by 90% and to treat 80% of eligible cases by 2030. 1-3 Screening detects cases before symptoms develop and allows early treatment, thus potentially reducing disease burden. 4,5 Recently, direct-acting antivirals have transformed HCV infection treatment, offering high cure rates with improved tolerability over interferon-based treatments. 6 The high costs of direct-acting antivirals initially restricted access in many jurisdictions, including Canada. 7 However, time-limited agreements negotiated between Canadian provincial drug plans and pharmaceutical manufacturers allowed governments of most provinces to fully cover direct-acting antiviral treatment for all eligible patients with chronic HCV infection in 2018 and 2019. 8,9 Economic evaluations are essential in such negotiations. Given that the current agreements may expire in 2-3 years and renegotiations will begin, accurate, up-to-date cost estimates for economic evaluations are critical for effective policy-making. 10 Furthermore, estimates of the cost of illness are important for priority setting and forecasting.

Time Costs and Out-of-Pocket Costs in Patients With Chronic Hepatitis C in a Publicly Funded Health System

“…3 Another study suggested that the financial burden of HCV to the health system is also high. 40 Our study reveals that the financial burden on patients is also high: 3-month OOP costs and patient time costs represented 10.6% and 20.7% of the patient-reported total income for the hospital-based and community-based cohorts, respectively. The burden on caregivers was also considerable.…”

Global Elimination of HCV—Why Is Poland Still So Far from the Goal?

“…As a consequence, the current scenario does not provide a solution that would definitely limit the scale of infection and the range of activities related to the treatment of the outcomes and complications [ 18 , 19 , 20 ].…”

Cost-effectiveness of obeticholic acid for the treatment of non-alcoholic steatohepatitis: An early economic evaluation

“…As the drug cost does not appear to be dose-dependent and the indication-specific drug price for NASH is unavailable, we assumed in our model an average daily drug cost for once daily OCA 25 mg to also be $98.63, resulting in an annual price of $36,000. Costs associated with end-stage liver diseases, such as DC and HCC, were estimated from a hepatitis C study as NASH-specific data are unavailable ( Table 1 ) ( 14 ). While NASH-specific end-stage liver disease costs in the United States and Europe have previously been reported and widely cited in the literature, it is important to note that these costs were also derived from hepatitis C studies ( 15 ).…”