IN1 - Impact of Sofosbuvir-Based Regimens for Chronic Hepatitis C Infection: A Work Productivity Model from Mainland China

Abstract

Chronic Hepatitis C (CHC) imposes a considerable disease burden in China. There are approximately 10 million Chinese CHC patients, the majority of which are genotype 1 (GT1). Untreated infections are associated with a poor clinical prognosis and impairment in work productivity (WP), which has not been comprehensively evaluated in mainland China. This study models the impact of CHC infection on WP in China and estimates potential WP gains associated with ledipasvir/sofosbuvir (LDV/SOF) and sofosbuvir/velpatasvir (SOF/VEL) treatments, which are currently under review by China FDA. An economic model was developed to assess the impact of treatment with LDV/SOF on WP over a one-year period, with patients entering the model post-treatment, having achieved sustained virological response at 12 weeks (SVR12), or not. Absenteeism (absence from work) and presenteeism (reduced productivity at work) rates were extracted from the Phase III ION and ASTRAL trials as measured by the Work Productivity and Activity Index-Specific Health Problem questionnaire (WPAI-SHP); rates were assumed to be unchanged from baseline for patients not achieving SVR12. These rates were converted into hours of lost productivity, multiplied by the average working wage, total employment rate, and adult GT1 population in mainland China. We assumed universal treatment with either LDV/SOF or SOF/VEL in the model and contrasted the results relative to no treatment. Total annual work productivity loss due to not treating GT1 CHC patients was estimated to be around ¥18.11 billion. Treatment with sofobusvir-based regimens resulted in estimated productivity gains of ¥6.85 billion, primarily due to reduced presenteeism. Productivity losses due to untreated HCV infection represent a substantial indirect economic burden in China. Treatment with sofobusvir-based regimens is likely to result in substantial economic savings for society versus no treatment, which should be considered when assessing the value of CHC treatment.