Health utilities and psychometric quality of life in patients with early‐ and late‐stage hepatitis C virus infection

Hsu, Priscilla C; Federico, Carole A; Krajden, Mel; Yoshida, Eric M.; Bremner, Karen E.; Anderson, Frank H.; Weiss, Alan; Krahn, Murray

doi:10.1111/j.1440-1746.2011.06813.x

Cited by 67 publications

(75 citation statements)

References 47 publications

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“…Hepatitis C infection is known to cause impairment in quality of life by itself. 6,38 The major proportion of its impact onto health status of the patient is manifested at advanced stages when symptoms of severe liver damage or hepatitis C-associated metabolic disorders occur. Until then, hepatitis C infection is generally asymptomatic and minimally affects individual's dayto-day well-being.…”

Section: Discussionmentioning

confidence: 99%

Patients' preferences and health utility assessment with SF‐6D and EQ‐5D in patients with chronic hepatitis C treated with sofosbuvir regimens

Stepanova

Nader

Cure

et al. 2014

Aliment Pharmacol Ther

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Summary Background Health utilities measure patients' preferences for a health state. Aim To assess health utilities for sofosbuvir‐containing therapy for chronic hepatitis C. Methods The SF‐6D utility scores were derived from the SF‐36 instrument administered at baseline, during and post‐treatment to participants of the previously reported clinical trials of sofosbuvir. EQ‐5D utility scores were also approximated from the SF‐36 using a regression model. Results Nine hundred and ninety‐four patients were enrolled. Baseline SF‐6D and EQ‐5D scores were 0.66 ± 0.13 and 0.71 ± 0.22, respectively (the POSITRON trial), 0.71 ± 0.16 and 0.76 ± 0.23 (FISSION), 0.70 ± 0.14 and 0.75 ± 0.22 (FUSION), 0.72 ± 0.15 and 0.79 ± 0.22 (NEUTRINO). In all studies, SF‐6D and EQ‐5D scores were highly correlated with each other. (r = 0.83–0.87, P < 0.0001). After 12 weeks, patients receiving sofosbuvir + ribavirin (POSITRON) had similar utility scores to placebo (P > 0.05). Patients receiving 12 and 16 weeks of sofosbuvir + ribavirin (FUSION) had similar utility scores (P > 0.05). In FISSION, patients receiving sofosbuvir + ribavirin had significantly better utilities compared to patients receiving interferon + ribavirin (P < 0.001). Patients receiving sofosbuvir + ribavirin + interferon (NEUTRINO) had a decrease in utilities during treatment (SF‐6D: from 0.72 to 0.62, EQ‐5D: 0.79 to 0.65; P < 0.0001) similar to that observed in patients receiving pegylated interferon + ribavirin for 24 weeks in FISSION (0.72 to 0.62 and 0.77 to 0.65, respectively, P < 0.0001). After 12 weeks post‐treatment, patients with SVR (FUSION) had improvement in SF‐6D (+0.026 from baseline, P = 0.013) and EQ‐5D (+0.043, P = 0.013). In multivariate analyses, baseline depression, anxiety, fatigue, insomnia and treatment‐related anaemia were the most consistent predictors of utilities. Conclusions Patients' health utilities are minimally impacted by sofosbuvir + ribavirin treatment, as compared to interferon‐based, therapy regardless of treatment duration. Clinical trials' numbers: NCT01542788 (POSITRON), NCT01497366 (FISSION), NCT01604850 (FUSION), NCT01641640 (NEUTRINO).

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Section: Discussionmentioning

confidence: 99%

Patients' preferences and health utility assessment with SF‐6D and EQ‐5D in patients with chronic hepatitis C treated with sofosbuvir regimens

Stepanova

Nader

Cure

et al. 2014

Aliment Pharmacol Ther

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“…We obtained utility data for various health states from the most recent and valid Canadian utility study available, published by Hsu and colleagues 47 in 2012 and based on the Health Utilities Index Mark 2. That study included 700 patients across different chronic HCV infection health states.…”

Section: Model Parametersmentioning

confidence: 99%

“…Compared with no screening, this Note: HCV = hepatitis C virus. *The study 47 did not include patients with decompensated cirrhosis, so utility for these patients was determined by adjusting the chronic HCV infection utility score according to a disutility value published in the systematic review. 48 approach resulted in a net cost increment of $266 and 0.0077 QALYs gained per person, which translated to an incremental cost-effectiveness ratio of $34 783 per QALY gained (Table 3).…”

Section: Model Validationmentioning

confidence: 99%

Cost-effectiveness of screening for hepatitis C in Canada

Wong

Feld

et al. 2015

CMAJ

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Background:The seroprevalence of hepatitis C virus (HCV) infection among Canadians is estimated at 0.3% to 0.9%. Of those with chronic HCV infection, 10% to 20% will experience advanced liver disease by 30 years of infection. Targeted screening seems a plausible strategy. We aimed to estimate the health and economic effects of various screening and treatment strategies for chronic HCV infection in Canada. Methods:We used a state-transition model to examine the cost-effectiveness of 4 screening strategies: no screening; screen and treat with pegylated interferon plus ribavarin; screen and treat with pegylated interferon and ribavarinbased direct-acting antiviral agents; and screen and treat with interferon-free direct-acting antivirals. We considered Can adian residents in 2 age groups: 25-64 and 45-64 years of age. We obtained model data from the literature. We predicted deaths related to chronic HCV infection, costs, quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratios. Results:We found that screening and treating would prevent at least 9 HCV-related deaths per 10 000 persons screened over the lifetime of the cohort. Screening was associated with QALY increases of 0.0032 to 0.0095 and cost increases of $124 to $338 per person, which translated to an incremental cost-effectiveness ratio of $34 359 to $44 034 per QALY gained, relative to no screening, depending on age group screened and antiviral therapy received.Interpretation: A selective one-time HCV screening program for people 25-64 or 45-64 years of age in Canada would likely be cost-effective. Identification of silent cases of chronic HCV infection and the offer of treatment when appropriate could extend the lives of Canadians at reasonable cost. Abstract Research E111CMAJ, February 17, 2015, 187(3)

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“…33 Treatment efficacy and safety inputs were generated directly from the network meta-analysis model. 15 Health states utility data were obtained from the most recent and valid Canadian utility study available, conducted by Hsu and colleagues 26 in 2012, using Health Utilities Index Mark 2. The study included 700 patients across different chronic hepatitis C health states.…”

Section: Model Parametersmentioning

confidence: 99%

“…5,[16][17][18]20,[22][23][24][25][26][27][28][29][30][31][32] All cost data were expressed in Canadian dollars and were inflated to 2015 using the Statistics Canada Consumer Price Index for health care and personal items. 33 Treatment efficacy and safety inputs were generated directly from the network meta-analysis model.…”

Section: Model Parametersmentioning

confidence: 99%

Drug therapies for chronic hepatitis C infection: a cost-effectiveness analysis

et al. 2017

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Health utilities and psychometric quality of life in patients with early‐ and late‐stage hepatitis C virus infection

Abstract: The effect of stage of disease on HRQOL is modest, although viral clearance is associated with higher HRQOL. HCV patients' HRQOL is strongly associated with concomitant illness and sociodemographic factors.

Cited by 67 publications

References 47 publications

Patients' preferences and health utility assessment with SF‐6D and EQ‐5D in patients with chronic hepatitis C treated with sofosbuvir regimens

Patients' preferences and health utility assessment with SF‐6D and EQ‐5D in patients with chronic hepatitis C treated with sofosbuvir regimens

Cost-effectiveness of screening for hepatitis C in Canada

Drug therapies for chronic hepatitis C infection: a cost-effectiveness analysis

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