PGI29 - Burden of Chronic Hepatitis C (CHC) from the Patient Perspective: A Literature Review and Conceptual Map

Abstract

The burden of CHC is typically expressed in terms of its impact on the healthcare system and to society. The aims of this literature review and assessment were to characterize the burden of CHC from the patient perspective and to create a conceptual map of factors that influence this. A targeted Medline search was conducted for the years 2010-present using the terms hepatitis C, burden, quality of life, symptoms, employment, and costs. Prospective, retrospective, and cross-sectional studies that reported on the humanistic and/or economic burden of CHC from the patient’s perspective were included. Upon identifying and summarizing key themes and supporting data, a conceptual map of factors that contribute either positively or negatively to patient burden was constructed. Themes consisting of an interplay of humanistic burden (consisting of emotional and psychosocial impact and health-related quality of life (HRQoL)) economic burden (including work productivity, associated indirect costs, and out-of-pocket (OOP) costs) and treatment impact were identified. Resulting in a conceptual map that indicates that stigmatization can lead to social isolation, symptoms of depression and anxiety, social isolation, and poor HRQoL, which in turn impact work productivity and willingness to access care. Impaired work productivity leads to indirect costs, which can further worsen already poor socioeconomic status. Higher OOP costs in patients who are already economically disadvantaged not only further worsens their economic situation but can be a barrier to accessing care. Among those who do receive treatment, reductions in symptoms, improvement in HRQoL and work productivity have been demonstrated. The humanistic and economic impact of CHC are important determinants of access to care and the benefits of treatment. The burden of CHC from the patient’s perspective is an important and underrecognized component of the overall societal impact of disease.