An Estimate of the Cost of Hepatitis C Treatment for the Brazilian Health System

Blatt, Carine Raquel; Bernardo, Noemia Liege Maria da Cunha; Rosa, Júnior André da; Bagatini, Fabíola; Alexandre, R.F.; Neto, Giácomo Balbinotto; Siebert, Uwe; Farías, Mareni Rocha

doi:10.1016/j.vhri.2012.10.001

Cited by 11 publications

(11 citation statements)

References 16 publications

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“…These costs were higher than direct costs of other chronic condition in Brazilian populations, such as diabetes (USD 1,012) (44) , and non-melanoma skin cancer (BRL 1,172) (45) ; but lower than rheumatoid arthritis (BRL 19,860.16) (46) . In addition, the results showed that drug treatment was the costliest component, accounting for 95.9% of total HCV costs; accordingly, a Brazilian study conducted prior to the incorporation of protease inhibitors have shown that drug treatment represented 88.2% of the total costs (47) .…”

Section: Discussionmentioning

confidence: 99%

Hepatitis C in the Brazilian Public Health Care System: Burden of Disease

Castelo

Mello

Teixeira

et al. 2018

Arq. Gastroenterol.

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BACKGROUND: Infection by hepatitis C virus is one of the leading causes of chronic hepatitis C and cause severe burden for patients, families and the health care system. OBJECTIVE: The aims of this research were to assess the severity of liver fibrosis, comorbidities and complications of hepatitis C virus; to examine health-related quality of life (HRQoL), productivity loss and resource use and costs in a sample of Brazilian chronic hepatitis C, genotype 1, patients. METHODS: This was a cross-sectional multicenter study performed in genotype-1 chronic hepatitis C patients to assess disease burden in the Brazilian public health care system between November 2014 and March 2015. Patients were submitted to a liver transient elastography (FibroScan) to assess liver fibrosis and answered an interview composed by a questionnaire specifically developed for the study and three standardized questionnaires: EQ-5D-3L, HCV-PRO and WPAI:HepC. RESULTS: There were 313 subjects enrolled, with predominance of women (50.8%), caucasian/white (55.9%) and employed individuals (39.9%). Mean age was 56 (SD=10.4) years old. Moreover, 42.8% of patients who underwent FibroScan were cirrhotic; the most frequent comorbidity was cardiovascular disease (62.6%) and the most frequent complication was esophageal varices (54.5%). The results also showed that “pain and discomfort” was the most affected HRQoL dimension (55.0% of patients reported some problems) and that the mean HCV-PRO overall score was 69.1 (SD=24.2). Regarding productivity loss, the most affected WPAI:HepC component was daily activity (23.5%) and among employed patients, presenteeism was more frequent than absenteeism (18.5% vs 6.5%). The direct medical costs in this chronic hepatitis C sample was 12,305.72USD per patient in the 2 years study period; drug treatment costs represented 95.9% of this total. CONCLUSION: This study showed that most patients are cirrhotic, present high prevalence of cardiometabolic diseases and esophageal varices, reduced HRQoL mainly in terms of pain/discomfort, and work productivity impairment, especially presenteeism. Additionally, we demonstrated that hepatitis C virus imposes an economic burden on Brazilian Health Care System and that most of this cost is due to drug treatment.

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Section: Discussionmentioning

confidence: 99%

Hepatitis C in the Brazilian Public Health Care System: Burden of Disease

Castelo

Mello

Teixeira

et al. 2018

Arq. Gastroenterol.

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“…The analyses performed here excluded the costs of antiviral and co-medications, which typically constitute the largest part of the total treatment costs for HCV patients [ 34 , 35 ]. The reason for this was that the first aim of this study was to identify patient and treatment characteristics that would influence MRU—and thus the total cost of care—so that these could be better managed, as in other therapeutic areas, such as oncology, diabetes and human immunodeficiency virus (HIV) infection [ 36 – 38 ].…”

Section: Resultsmentioning

confidence: 99%

“…The MRU-related costs in our study were within the ranges of treatment costs previously published. In the German context, the costs for outpatient visits were €355 (£293), which represent about 2 % of the total treatment cost for HCV patients [ 34 , 35 , 39 ]. Athanasakis et al [ 40 ] estimated the annual cost per patient for patients with a METAVIR score of F0–F3 to be €643 (£530), excluding the cost of medications.…”

Section: Resultsmentioning

confidence: 99%

Predicting the Impact of Adverse Events and Treatment Duration on Medical Resource Utilization-Related Costs in Hepatitis C Genotype 1 Treatment-Naïve Patients Receiving Antiviral Therapy

Akpo¹,

Cerri

Kleintjens³

2015

PharmacoEconomics

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ObjectivesStudies on medical resource utilization (MRU) and related costs are important for evaluating the potential patient management and cost-effectiveness implications of antiviral treatments for hepatitis C virus (HCV) infection. The objectives of this study were (i) to compare the MRU and related costs for two treatment approaches; (ii) to identify the main drivers of resource use and costs; and (iii) to assess the effects of various treatment regimen attributes on MRU-related costs in a UK clinical setting.MethodsThe analysis used data collected alongside the simeprevir (SMV) phase III trials for treatment-naïve genotype 1 HCV-infected patients; these data covered outpatient consultations with specialists, emergency room visits and hospital admissions. Logistic regressions were constructed to estimate the predictors of resource utilization, and a two-part multivariable analysis model was used to determine the total costs of treatment in the UK.ResultsData on 731 patients receiving SMV plus pegylated interferon and ribavirin (SMV/PegIFN/R) or PegIFN/R were included in the analysis. While MRU was similar between the SMV and PegIFN/R groups, MRU-related costs were significantly lower in the SMV group than in the PegIFN/R group (P < 0.05). High body mass index (P < 0.05), severe fibrosis (P < 0.05), shortened treatment duration to 24 weeks (P < 0.05), and anaemia and rash during treatment (P < 0.001) were identified as predictors of hospitalization and outpatient visits and as drivers of total costs. Univariate sensitivity analyses suggested that shortened treatment duration and lower occurrence of rash lead to large cost savings.ConclusionThis study identified both baseline and on-treatment antiviral therapy characteristics as drivers of MRU-related costs for HCV patients following antiviral therapy. The shortened treatment duration and reduction in rash due to treatment with SMV triple therapy lead to substantial non-drug cost savings, compared with PegIFN/R treatment. This suggests that there are potential patient management and cost-effectiveness implications associated with the choice of specific antiviral treatments.Electronic supplementary materialThe online version of this article (doi:10.1007/s40273-014-0249-4) contains supplementary material, which is available to authorized users.

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“…Anti-virals are among the main therapeutic classes of the cohort studied, including anti-retroviral agents and drugs for hepatitis. Viral hepatitis is currently a public health concern and the drug access program has been expanded through the specialized component of pharmaceutical assistance 38 . Brazil has shown sustained advances in biomedical, clinical and epidemiological research on issues involving the prevention and treatment of infectious diseases 35 .…”

Section: Discussionmentioning

confidence: 99%

Análise de medicamentos novos registrados no Brasil na perspectiva do Sistema Único de Saúde e da carga de doença

Botelho

Martins

Reis

2018

Ciênc. saúde coletiva

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An Estimate of the Cost of Hepatitis C Treatment for the Brazilian Health System

Abstract: In Brazil, antiviral drugs are the most expensive component of hepatitis C treatment. The cost of follow-up and support to patients is minimal compared with the cost of antiviral drugs.

Cited by 11 publications

References 16 publications

Hepatitis C in the Brazilian Public Health Care System: Burden of Disease

Hepatitis C in the Brazilian Public Health Care System: Burden of Disease

Predicting the Impact of Adverse Events and Treatment Duration on Medical Resource Utilization-Related Costs in Hepatitis C Genotype 1 Treatment-Naïve Patients Receiving Antiviral Therapy

Análise de medicamentos novos registrados no Brasil na perspectiva do Sistema Único de Saúde e da carga de doença

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