PGI15 The Cost and Quality of Life of Hepatitis C in the Netherlands

Hepatitis C (HCV) is a disease which in the long run can lead to cirrhosis and liver cancer, resulting in liver transplantation or death if not treated properly. So far, there is a paucity of literature on health care costs and quality of life (QoL) of HCV management. This study aims to illustrate the health care costs and QoL associated with HCV in The Netherlands. This study followed a cross-sectional design for QoL and indirect costs, and a retrospective design for direct costs (these were mapped retrospectively until 3 years ago or diagnosis of HCV if earlier). Patients with HCV genotype 1 at Erasmus MC were invited to participate between November 2010 and April 2011. Patients were asked to complete the EQ-5D, Short form 36 (SF-36), Liver disease symptom index (LDSI) and Short form health and labour questionnaire (SF-HLQ). Resource use data were collected from the hospital information system. Utilities were determined using the UK tariff for EQ-5D The Mann-Whitney U-test was used for comparisons between treated and non-treated patients for the disease categories, mild and moderate disease and cirrhosis. Thirty-seven patients had either completed or discontinued treatment during the observation period, 10 had achieved sustained viral response (SVR). Mean direct costs were higher for treated patients, during all 3 years of observation; 3286 versus 5361, 1336 versus 9440, 2538 versus 10.507, (p<0.01). Compared to non-responders successfully treated patients had lower follow-up costs 1 year after treatment, 1172 versus 1426, and a higher mean utility, 0.84 versus 0.70, neither result was statistically significant at p=0.4 and p=0.2. There were no significant differences in indirect costs. This study provides basic information about the costs and utility of hepatitis C treatment. Such information is valuable when considering cost-effectiveness of new treatments for this disease.