title: The burden of illness for patients with viral hepatitis C: evidence from a national survey in Japan.
abstract: OBJECTIVE
  Viral hepatitis C (HCV) affects 170 million patients worldwide and 2 million patients in Japan. The objective of the current study was to examine the burden of HCV in Japan from a patient's perspective.
  
  
  METHODS
  Using data from the 2008 and 2009 Japan National Health and Wellness Surveys, patients who reported an HCV diagnosis (n = 306) were compared with a propensity-score-matched control group (n = 306) on measures of quality of life (using the Medical Outcomes Study 12-Item Short Form Survey Instrument version 2), work productivity (using the Work Productivity and Activity Impairment questionnaire), and health-care resource use. All analyses applied sampling weights to project to the population.
  
  
  RESULTS
  Prior to matching, patients with HCV had higher rates of hepatocellular carcinoma (4.88% vs. 0.02%) and cirrhosis (12.20% vs. 0.11%) than did subjects without HCV. The propensity-matching process eliminated differences between the two groups on demographics and patient characteristics. The postmatching analysis found significantly lower levels of quality of life for patients with HCV as measured by bodily pain (72.07 vs. 76.28), general health (44.64 vs. 48.61), and mental health (66.50 vs. 70.32) (all Ps < 0.05). Furthermore, compared with the matched group, the HCV group had significantly higher workplace absenteeism (8.59% vs. 4.12%), overall work impairment (26.08% vs. 17.32%), and health-care provider visits in the past 6 months (14.80 vs. 9.74).
  
  
  CONCLUSIONS
  The results of this study suggest that HCV can be a substantial burden on patients in terms of quality of life in both physical and mental health measures. In addition, HCV can be a significant cost driver in terms of health-care use and lost productivity.
authors.affiliation: Guanghua School of Management, Peking University, Peking, China.
authors.forename: Gordon G
authors.initials: GG
authors.lastname: Liu
authors.forename: Marco daCosta
authors.initials: Md
authors.lastname: DiBonaventura
authors.forename: Yong
authors.initials: Y
authors.lastname: Yuan
authors.forename: Jan-Samuel
authors.initials: JS
authors.lastname: Wagner
authors.forename: Gilbert J
authors.initials: GJ
authors.lastname: L'Italien
authors.forename: Paul
authors.initials: P
authors.lastname: Langley
authors.forename: Isao
authors.initials: I
authors.lastname: Kamae
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000191:economics / Q000209:etiology; D017281:Cost of Illness; D004526:Efficiency; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006304:Health Status; D006526:Hepatitis C / Q000150:complications / Q000191:economics*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000191:economics / Q000209:etiology; D008113:Liver Neoplasms / Q000191:economics / Q000209:etiology; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011788:Quality of Life; D055815:Young Adult