Estimating the impact of hepatitis C virus therapy on future liver-related morbidity, mortality and costs related to chronic hepatitis C.
OBJECTIVE
Chronic Hepatitis C virus (HCV) infection is common and often produces a progressive disease. Some studies suggest that HCV related complications will increase in the future. Our aim was to estimate the future morbidity, mortality and costs of chronic HCV infection in a cohort of patients infected by HCV and to evaluate the impact of HCV therapy.


METHODS
A mathematical model was used to project over the next 30 years, the HCV related complications and costs in a cohort of 419,895 infected patients representing the HCV infected population in Spain. The impact of HCV therapy with peginterferon and ribavirin in this population was also projected.


RESULTS
A gradual decline in the infected population is expected in the future, however, the proportion of patients with cirrhosis will increase by up to 14% and morbidity associated with HCV infection by up to 10% by the year 2030 with a subsequent increment in HCV related costs. However, treating from 10 to 50% of the HCV population will result in a reduction of 6 and 26% in morbidity and 4 and 20% in mortality, respectively. The cost per year of life gained ranges from 6078 for a 29-year-old patient to 8911 for a 59-year-old patient.


CONCLUSIONS
In the future, HCV infection mortality, morbidity and associated costs will increase. Treatment of the chronic HCV infected population can eradicate the infection, increase patients' survival and reduce the need for liver transplantation, making this a cost-effective strategy.
Buti
María
M
Department of Hepatology, Hospital Vall d'Hebrón, Barcelona, Spain. mbuti@vhebron.net
San Miguel
Ramón
R
Brosa
Max
M
Cabasés
Juan M
JM
Medina
Montserrat
M
Angel Casado
Miguel
M
Fosbrook
Leslie
L
Esteban
Rafael
R
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000998:Antiviral Agents / Q000191:economics* / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D017048:Health Care Costs / Q000706:statistics & numerical data* / Q000639:trends; D019698:Hepatitis C, Chronic / Q000188:drug therapy / Q000191:economics / Q000401:mortality / Q000503:physiopathology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008103:Liver Cirrhosis; D008390:Markov Chains; D008875:Middle Aged; D015233:Models, Statistical; D013030:Spain / Q000453:epidemiology
D000998:Antiviral Agents