Medical resource utilization and costs among Australian patients with genotype 1 chronic hepatitis C: results of a retrospective observational study

Abstract

CHC-related MRU increases substantially with disease severity. These real-world MRU data for GT1 CHC will be valuable in assessing the impact of new hepatitis C treatments.

Direct-Acting Antivirals Remain Cost-Effective Treatments for Chronic Hepatitis C in Australia Despite Changes to the Treated Population and the Availability of Retreatment: The Glecaprevir/Pibrentasvir (Maviret®) Example

“…Resource use for the Markov health states was collected from medical records for a stratified random sample of 276 GT1 patients first attending two Australian liver clinics between January 2011 and December 2013, and supplemented by 112 GT1 patients attending one liver transplant clinic in the same period; patients were followed to June 30, 2014 [ 4 ]. The sample included in the medical resource utilization (MRU) audit was restricted to patients attending treatment centers.…”

“… HCC hepatocellular carcinoma, HCV hepatitis C virus, SVR12 sustained virological response 12 weeks post cessation of therapy a MRU informed by expert opinion, unit costs taken from Medicare Benefits Schedule [ 58 ] b Inflated to 2023 dollars using the medical and hospital services component of the Consumer Price Index [ 59 ] c Similar to other Australian analyses, decompensated disease (DCC) was kept as a single health state rather than subdividing into its different clinical manifestations (such as ascites, variceal hemorrhage, hepatic encephalopathy). Therefore, the utility scores for ascites, variceal hemorrhage, hepatic encephalopathy presented in Szabo 2015 [ 34 ] were weighted based on demographic data collected in the audit [ 4 ] to generate a single utility score for DCC d McElroy 2015 [ 4 ] found that the resource use for DCC patients attending a liver transplant clinic is higher ($31,221) than the resource use for DCC patients managed at a liver clinic ($15,674). The analysis arbitrarily assumes that 75% of DCC patients undergo their treatment at a liver clinic and the remaining 25% undergo their treatment at a transplant clinic e Unit cost of liver transplant based on AR-DRG inpatient cost in that year [ 60 ] …”

“…c Similar to other Australian analyses, decompensated disease (DCC) was kept as a single health state rather than subdividing into its different clinical manifestations (such as ascites, variceal hemorrhage, hepatic encephalopathy). Therefore, the utility scores for ascites, variceal hemorrhage, hepatic encephalopathy presented in Szabo 2015 [ 34 ] were weighted based on demographic data collected in the audit [ 4 ] to generate a single utility score for DCC…”

“…Chronic hepatitis C virus infection, when left untreated, may result in fibrosis and cirrhosis, which can further progress to liver disease, resulting in considerable morbidity, mortality, and cost burden [ 3 , 4 ]. The availability of direct-acting antiviral (DAA) therapies has transformed clinical management for HCV, providing potentially curative, well-tolerated, short-term treatments [ 5 ].…”

Hepatocellular carcinoma surveillance in Australia: time to improve the diagnosis of cirrhosis and use liver ultrasound

“…However, survival remains poor and HCC is the only low survival cancer of all the cancers that are rapidly increasing in incidence in Australia . The average cost to treat HCC is $50 000 and liver transplantation costs $166 000 . Therefore, with incidence showing no signs of slowing, health system costs will continue to increase substantially in the absence of preventive actions.…”