Resource Utilization and Direct Medical Costs of Chronic Hepatitis C in Thailand: A Heavy but Manageable Economic Burden

Thongsawat, Satawat; Piratvisuth, Teerha; Pramoolsinsap, Chutima; Chutaputti, Anuchit; Tanwandee, Tawesak; Thongsuk, Dittaya

doi:10.1016/j.vhri.2013.09.002

Cited by 14 publications

(8 citation statements)

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“…Direct non-medical costs included transportation and food expenditure of patients. The number of OPD visits, IPD admissions and length of stay were retrieved from the existing study conducted in Thailand [ 33 ]. The unit costs of transportation and food expenditure were derived from Thai Standard Cost List for Health Technology Assessment [ 34 ].…”

Section: Methodsmentioning

confidence: 99%

Economic evaluation of pegylated interferon plus ribavirin for treatment of chronic hepatitis C in Thailand: genotype 1 and 6

2016

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BackgroundPegylated interferon alpha 2a, alpha 2b and ribavirin have been included to the National List of Essential Medicines (NLEM) for treatment of only chronic hepatitis C genotypes 2 and 3 in Thailand. This reimbursement policy has not covered for other genotypes of hepatitis C virus infection (HCV) especially for genotypes 1 and 6 that account for 30-50 % of all HCV infection in Thailand. Therefore, this research determined whether pegylated interferon alpha 2a or alpha 2b plus ribavirin is more cost-effective than a palliative care for treatment of HCV genotype 1 and 6 in Thailand.MethodsA cost-utility analysis using a model-based economic evaluation was conducted based on a societal perspective. A Markov model was developed to estimate costs and quality-adjusted life years (QALYs) comparing between the combination of pegylated interferon alpha 2a or alpha 2b and ribavirin with a usual palliative care for genotype 1 and 6 HCV patients. Health-state transition probabilities, virological responses, and utility values were obtained from published literatures. Direct medical and direct non-medical costs were included and retrieved from published articles and Thai Standard Cost List for Health Technology Assessment. The incremental cost-effectiveness ratio (ICER) was presented as costs in Thai baht per QALY gained.ResultsHCV treatment with pegylated interferon alpha 2a or alpha 2b plus ribavirin was dominant or cost-saving in Thailand compared to a palliative care. The ICER value was negative with lower in total costs (peg 2a- 747,718vs. peg 2b- 819,921 vs. palliative care- 1,169,121 Thai baht) and more in QALYs (peg 2a- 13.44 vs. peg 2b- 13.14 vs. palliative care- 11.63 years) both in HCV genotypes 1 and 6.ConclusionAs cost-saving results, the Subcommittee for Development of the NLEM decided to include both pegylated interferon alpha 2a and alpha 2b into the NLEM for treatment of HCV genotype 1 and 6 recently. Economic evaluation for these current drugs can be further applied to other novel medications for HCV treatment.

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Section: Methodsmentioning

confidence: 99%

Economic evaluation of pegylated interferon plus ribavirin for treatment of chronic hepatitis C in Thailand: genotype 1 and 6

2016

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“…The treatment costs only related to NAFLD and NASH. As the costs for compensated cirrhosis, decompensated cirrhosis, and HCC are not available, they were assumed to be the same as for hepatitis C patients and were adapted from a country-speci c study [40]. All costs were adjusted using the Consumer Price Index and reported in 2019 US Dollars (1 US Dollar = 32.3 Thai Baht) [41,42].…”

Section: Costsmentioning

confidence: 99%

WITHDRAWN: Economic Burden of Non-Alcoholic Steatohepatitis with Significant Fibrosis in Thailand

Phisalprapa

Prasitwarachot

Kositamongkol

et al. 2020

Preprint

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Background: Non-alcoholic steatohepatitis (NASH) has been recognised as a significant form of chronic liver disease and a common cause of cirrhosis and hepatocellular carcinoma, resulting in a considerable financial burden on healthcare resources. Currently, there is no information regarding the economic burden of NASH in low- and middle-income countries (LMICs). The aim of this study was to estimate the economic burden of NASH in Thailand as a lesson learned for LMICs.Methods: To estimate the healthcare costs and prevalence of NASH with significant fibrosis (fibrosis stage ≥ 2) in the general Thai population, an eleven-state lifetime horizon Markov model with 1-year cycle length was performed. The model comprised Thai population aged 18 years and older. The cohort size was based on Thailand Official Statistic Registration Systems. The incidence of NASH, transitional probabilities, and costs-of-illness were based on previously published literature, including systematic reviews and meta-analyses. The age-specific prevalence of NASH was based on Thai NASH registry data. Costs were expressed in 2019 US Dollars ($). As we undertook analysis from the payer perspective, only direct medical costs were included. All future costs were discounted at an annual rate of 3%. A series of sensitivity analyses were performed.Results: The estimated total number of patients with significant NASH was 2.9 million cases in 2019, based on a NASH prevalence of 5.74%. The total lifetime cost of significant NASH was $15.2 billion ($5,147 per case), representing approximately 3% of the 2019 GDP of Thailand. The probabilistic sensitivity analysis showed that the lifetime costs of significant NASH varied from $11.4 billion to $18.2 billion.Conclusions: The economic burden associated with NASH is substantial in Thailand. This prompts clinicians and policy makers to consider strategies for NASH prevention and management.

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“…There are just a few studies assessing MRU in patients with CHC. In a retrospective and multicentre study, Thongsawat et al [ 42 ] evaluated MRU and direct medical costs of patients with CHC in Thailand. Though the most prevalent genotype in the Thai population is genotype 3, their results aligned with our findings—that is, less severe patients were less often admitted to hospitals and tended to have a shorter stay in the hospital than more severe patients did.…”

Section: Resultsmentioning

confidence: 99%

Predicting the Impact of Adverse Events and Treatment Duration on Medical Resource Utilization-Related Costs in Hepatitis C Genotype 1 Treatment-Naïve Patients Receiving Antiviral Therapy

Akpo¹,

Cerri

Kleintjens³

2015

PharmacoEconomics

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ObjectivesStudies on medical resource utilization (MRU) and related costs are important for evaluating the potential patient management and cost-effectiveness implications of antiviral treatments for hepatitis C virus (HCV) infection. The objectives of this study were (i) to compare the MRU and related costs for two treatment approaches; (ii) to identify the main drivers of resource use and costs; and (iii) to assess the effects of various treatment regimen attributes on MRU-related costs in a UK clinical setting.MethodsThe analysis used data collected alongside the simeprevir (SMV) phase III trials for treatment-naïve genotype 1 HCV-infected patients; these data covered outpatient consultations with specialists, emergency room visits and hospital admissions. Logistic regressions were constructed to estimate the predictors of resource utilization, and a two-part multivariable analysis model was used to determine the total costs of treatment in the UK.ResultsData on 731 patients receiving SMV plus pegylated interferon and ribavirin (SMV/PegIFN/R) or PegIFN/R were included in the analysis. While MRU was similar between the SMV and PegIFN/R groups, MRU-related costs were significantly lower in the SMV group than in the PegIFN/R group (P < 0.05). High body mass index (P < 0.05), severe fibrosis (P < 0.05), shortened treatment duration to 24 weeks (P < 0.05), and anaemia and rash during treatment (P < 0.001) were identified as predictors of hospitalization and outpatient visits and as drivers of total costs. Univariate sensitivity analyses suggested that shortened treatment duration and lower occurrence of rash lead to large cost savings.ConclusionThis study identified both baseline and on-treatment antiviral therapy characteristics as drivers of MRU-related costs for HCV patients following antiviral therapy. The shortened treatment duration and reduction in rash due to treatment with SMV triple therapy lead to substantial non-drug cost savings, compared with PegIFN/R treatment. This suggests that there are potential patient management and cost-effectiveness implications associated with the choice of specific antiviral treatments.Electronic supplementary materialThe online version of this article (doi:10.1007/s40273-014-0249-4) contains supplementary material, which is available to authorized users.

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Resource Utilization and Direct Medical Costs of Chronic Hepatitis C in Thailand: A Heavy but Manageable Economic Burden

Abstract: CHC was a costly disease in Thailand. The average annual medication cost was the largest portion in every health state, except HCV-related liver transplantation.

Cited by 14 publications

References 14 publications

Economic evaluation of pegylated interferon plus ribavirin for treatment of chronic hepatitis C in Thailand: genotype 1 and 6

Economic evaluation of pegylated interferon plus ribavirin for treatment of chronic hepatitis C in Thailand: genotype 1 and 6

WITHDRAWN: Economic Burden of Non-Alcoholic Steatohepatitis with Significant Fibrosis in Thailand

Predicting the Impact of Adverse Events and Treatment Duration on Medical Resource Utilization-Related Costs in Hepatitis C Genotype 1 Treatment-Naïve Patients Receiving Antiviral Therapy

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