Multicountry burden of chronic hepatitis C viral infection among those aware of their diagnosis: a patient survey.
BACKGROUND
The World Health Organization has called for global and regional assessments of the burden of hepatitis C (HCV) along with country-specific patient profiles to better inform healthcare policy. The present investigated the characteristics and burden of patients reporting a diagnosis of HCV infection in the US, France, Germany, Italy, Spain, the UK, urban China, and Japan using a consistent methodology of patient-reported surveys.


METHODS
The 2010 5EU (N = 57,805), 2009 US (N = 75,000), 2008/2009 Japan (N = 37,683), and 2009/2010 urban China (N = 33,261) waves of the National Health and Wellness Survey were used as the data source. Within each country, patients with a self-reported diagnosis of HCV were compared with those who did not report a diagnosis of HCV on sociodemographics, health behaviors, comorbidities, and health outcomes (e.g., Short Form-12v2). The effect of HCV was examined using regression analysis applying sampling weights.


RESULTS
The prevalence of HCV ranged from 0.26% (China) to 1.42% (Italy). Patients in Japan and Italy (61.60 and 61.02 years, respectively) were the oldest, while patients in the US were the most likely to be obese (39.31%) and have concomitant anxiety (38.43%) and depression (46.05%) compared with other countries. Pooling countries and adjusting for sociodemographics, health behaviors, and comorbidities, HCV was associated with significantly lower physical component summary scores (b = -2.51) and health utilities (b = -0.04) and greater overall work impairment (b = 8.79), physician visits (b = 2.91), and emergency department visits (b = 0.30) (all p<.05). The effects on health status were strongest in the US and UK while the effects on healthcare resource use were strongest in Japan.


CONCLUSIONS
HCV was associated with a significant humanistic and economic burden. These results suggest that the manifestation of the HCV burden, and the profile of the patients themselves, varied dramatically by country. Successful disease management should be cognizant of region-specific unmet needs.
Health Outcomes Practice, Kantar Health, New York, New York, United States of America.
Marco Dacosta
MD
Dibonaventura
Global Health Economics and Outcomes Research, Bristol-Myers Squibb, Princeton, New Jersey, United States of America.
Yong
Y
Yuan
Xintera Consulting, Brussels, Belgium.
Benedicte
B
Lescrauwaet
Global Health Economics and Outcomes Research, Bristol-Myers Squibb, Princeton, New Jersey, United States of America ; Yale University School of Medicine, New Haven, Connecticut, United States of America.
Gilbert
G
L'italien
National School of Development, Peking University, Beijing, China.
Gordon G
GG
Liu
Graduate School of Public Policy, The University of Tokyo, Tokyo, Japan.
Isao
I
Kamae
RTI International, Research Triangle Park, North Carolina, United States of America.
Josephine A
JA
Mauskopf
D017281:Cost of Illness; D003710:Demography; D004526:Efficiency; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006306:Health Surveys / Q000706:statistics & numerical data*; D016174:Hepacivirus / Q000502:physiology*; D019698:Hepatitis C, Chronic / Q000175:diagnosis* / Q000191:economics / Q000453:epidemiology*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D038622:Internationality; D008297:Male; D008875:Middle Aged