PIN24 Disease Burden of Progressive Chronic Hepatitis C in China

Abstract

To estimate the disease burden of progressive chronic hepatitis C (CHC) in China. A decision-analytic model was constructed to simulate the Chinese patients with progressive CHC and the age and gender-matched Chinese general population over lifetime time horizon for differences in overall survival, quality-adjusted life years (QALY), and lifetime direct medical costs. Literature search was conducted to identify appropriate evidence to estimate the model variables. Base case analysis and sensitivity analysis were conducted for the point estimations and uncertainty of the disease burden of progressive CHC. The base case analysis estimated that progressive CHC reduced the average overall survival by 9.701 years (24.320 years vs. 34.021 years), reduced average QALY by 10.480 QALY (19.611 QALY vs. 30.091 QALY), and increased average life-time direct medical costs by ¥45,472 (¥223,408 vs. ¥177,937). The lifetime QALY associated with CHC was highly sensitive to patient age of fibrosis stage 1 to 4 (change: 2.185 QALY, 2.508 QALY, 2.036 QALY, 3.157 QALY), and utility of fibrosis stage 4 patients (change: 1.375 QALY). The lifetime direct medical costs associated with CHC was highly sensitive to patient age of fibrosis stage 2 to 4 (change: ¥-30,270, ¥-28,305, ¥-40,345), direct medical cost (change: ¥29,844) and mortality (change: ¥-22,983) associated with hepatocellular carcinoma. The probabilistic sensitivity analysis with 10,000 Monte Carlo simulations estimated that the median and 95% credible interval of reduced QALY (-10.419 QALY, -11.532 QALY to -9.609 QALY) and increased lifetime direct medical costs ( ¥45,654, ¥39,414 to ¥54,000). The disease burden of progressive CHC in Chinese patients was mainly characterized with reduced overall survival and reduced QALY that were highly sensitive to patient age and quality of life associated with fibrosis stages.