Hepatitis C in the era of direct-acting antivirals: real-world costs of untreated chronic hepatitis C; a cross-sectional study.
BMC Infect Dis
; 15: 471, 2015 Oct 26.
Article
em En
| MEDLINE
| ID: mdl-26503519
ABSTRACT
BACKGROUND:
Recent advances in Hepatitis C therapeutics offer the possibility of cure but will be expensive. The cost of treatment may be partially offset by the avoidance of advanced liver disease. We performed a micro-costing study of the ambulatory healthcare utilisation of patients with Hepatitis C supplemented with inpatient diagnosis related group costs.METHODS:
The staff utilisation costs associated with a Hepatitis C ambulatory visit were measured and combined with the costs of investigations to establish a mean cost per consultation. An annualised estimate of cost was produced by multiplying this by the number of consultations accessed, stratified by degree of liver impairment. Inpatient costs were established by identifying the number of inpatient episodes and multiplying by Irish diagnosis related group costs. Non-parametric bootstrapping was performed to derive mean and 95%CI values.RESULTS:
Two hundred and twenty-five patients were identified. The cost of an outpatient medical review was 136 (3.60 SD). The cost of a Hepatitis C nursing review was 128 (7.30 SD). The annual mean costs of care were as follows (95%CI) Mild 398 (336, 482), Moderate 417(335, 503), Compensated cirrhosis 1790 (990, 3164), Decompensated cirrhosis 8302 (3945, 14,637), Transplantation Year 1 137,176 (136,024, 138,306), Transplantation after Year 1 5337 (4942, 5799), Hepatocellular carcinoma 21,992 (15,222, 29,467), Sustained virological response 44 (16, 73).CONCLUSIONS:
The direct medical cost associated with Hepatitis C care in Ireland is substantial and increases exponentially with progression of liver disease. The follow-up costs of patients with a sustained virological response in this cohort were low in comparison to patients with chronic infection.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Antivirais
/
Hepatite C
Tipo de estudo:
Health_economic_evaluation
/
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
BMC Infect Dis
Assunto da revista:
DOENCAS TRANSMISSIVEIS
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
Irlanda