Abstract
ObjectivesChronic hepatitis C (CHC) infection affects more than 70 million people worldwide and imposes considerable health and economic burdens on patients and society. This study estimated 2 understudied components of the economic burden, patient out-of-pocket (OOP) costs and time costs, in patients with CHC in a tertiary hospital clinic setting and a community clinic setting. MethodsThis was a multicenter, cross-sectional study with hospital-based (n = 174) and community-based (n = 101) cohorts. We used a standardized instrument to collect healthcare resource use, time, and OOP costs. OOP costs included patient-borne costs for medical services, nonprescription drugs, and nonmedical expenses related to healthcare visits. Patient and caregiver time costs were estimated using an hourly wage value derived from patient-reported employment income and, where missing, derived from the Canadian census. Sensitivity analysis explored alternative methods of valuing time. Costs were reported in 2020 Canadian dollars. ResultsThe mean 3-month OOP cost was $55 (95% confidence interval [CI] $21-$89) and $299 (95% CI $170-$427) for the community and hospital cohorts, respectively. The mean 3-month patient time cost was $743 (95% CI $485-$1002) (community) and $465 (95% CI $248-$682) (hospital). The mean 3-month caregiver time cost was $31 (95% CI $0-$63) (community) and $277 (95% CI $174-$380) (hospital). Patients with decompensated cirrhosis bore the highest costs. ConclusionsOOP costs and patient and caregiver time costs represent a considerable economic burden to patient with CHC, equivalent to 14% and 21% of the reported total 3-month income for the hospital-based and community-based cohorts, respectively.
Highlights
Hepatitis C virus (HCV) affects more than 70 million people worldwide[1,2] and imposes a substantial health burden.[3]
275 participants were included in the analyses, 101 (37%) from community clinics and 174 (63%) from the hospital clinics (Table 1)
decompensated cirrhosis (DC) and natural log income were significantly associated with caregiver time cost
Summary
Hepatitis C virus (HCV) affects more than 70 million people worldwide[1,2] and imposes a substantial health burden.[3] Approximately 15% to 45% of those infected clear the infection spontaneously. The remainder progress to chronic infection.[4,5] As many as 40% progress asymptomatically to cirrhosis and hepatocellular carcinoma (HCC), with an increased risk of premature death.[6,7,8] treatment for chronic hepatitis C (CHC) changed significantly with the advent of interferon-free direct-acting antiviral agents (DAAs) in 2014. Research has shown that DAAs are highly cost-effective.[10,11,12,13,14,15,16,17] DAAs have been approved and covered in many jurisdictions worldwide for treating patients with CHC
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