Hepatitis C among healthcare personnel: secondary data analyses of costs and trends for hepatitis C infections with occupational causes

Abstract

BackgroundHepatitis C infection is a global public health issue. Chronic hepatitis C infection is associated with significant morbidity and mortality. The aim of this study is to describe the costs for occupationally-cased hepatitis C infections based on data from an accident insurance carrier.MethodsThis study is a secondary analysis based on the Database of a German Institution for Statutory Accident Insurance. The analysis is based on a sample of insured parties whose hepatitis C infections were recorded as occupational diseases between 1996 and 2013. The analysis is based on recognised hepatitis C cases and incorporates records registered between 1 January 2000 and 31 December 2014.ResultsWithin the study period, the number of reported and recognised hepatitis C cases declined by 73 and 86% respectively. The majority of recognised hepatitis C cases (n = 1.121) were female, older than 40 years and were active in a medical nursing profession. In the study period, the costs came to a total of € 87.9 million, of which 60% was attributable to pension payments (€ 51,570,830) and around 15% was attributable to pharmaceutical and medicinal products (€ 12,978,318). Expenses for drugs exhibited heavy increases in 2012 (from around € 500,000–800,000 to € 1.7 million) and 2014 (to € 2.5 million) in particular. Pension payments came to € 1.6 million in 2000 and rose continuously to over € 4 million in 2014. Expenses for occupational rehabilitation accounted for less than 1%.ConclusionsFor hepatitis C infections as an occupational disease, a considerable increase in costs has been observed in recent years, while the number of reports has declined heavily. This rise in costs is explained by the increase in pension payments and, since 2012, by a rise in the costs for drugs. The high costs of anti-viral therapies is offset by the potential for considerable treatment benefits. Healing the infection is expected to generate long-term cost savings for statutory accident insurance carriers, and also for social security systems.

Infections in Healthcare Workers in Germany—22-Year Time Trends

“…However, from earlier projects it can be concluded that about 70% of all ODs in HWs concern hospitals or nursing homes [53]. About 75% of all HWs with OD-related infections are women [20].…”

“…For example, from 1996 to 2013 a total of 1121 hepatitis C infections in HWs were recognised as ODs in Germany and a total of EUR 52 million was paid to compensate for the loss of ability to work. A further EUR 36 million was paid for medical treatment of these HWs between 2000 and 2014 [20].…”

Hepatitis C in healthcare personnel: secondary data analysis of therapies with direct-acting antiviral agents

“…Data analyses showed an increase of costs associated with HCV as an OD in the period from 2000 to 2014 [ 12 ]. Despite lower OD HCV prevalence, the cost related to occupational exposure have increased in this period.…”

“…Data analysis of an accident insurer shows that despite the number of cases has declined, the costs of HCV infection as an occupational disease (OD) have been significantly increasing over the past 15 years. These costs are the result of the increase in compensation payments for retirement on the grounds of OD and, since 2012, as a result of an increase in the cost of the drugs used to treat the infection [ 12 ]. The high costs of DAA therapies are offset by the potentially considerable benefits.…”

Estado actual de la epidemiologí­a, diagnóstico, tratamiento y control de la hepatitis C

“…Se estima que casi el 40% de las infecciones por VHC en trabajadores de salud están asociadas a exposición laboral (Strasser et al, 2013). Pero la adquisición laboral de hepatitis C no es muy frecuente, aunque ha sido reportada en varios estudios, y ha ocurrido generalmente por pinchazos o cortaduras durante la atención a pacientes con hepatitis C (Egro et al, 2017;Strasser et al, 2013;Westermann, Dulon, Wendeler, & Nienhaus, 2016;Wicker et al, 2008).…”