title: Cost of treating hepatitis C in Germany: a retrospective multicenter analysis.
abstract: BACKGROUND
  Viral hepatitis is major a public health problem affecting millions of people worldwide. Estimates assume 400 000-500 000 people chronically infected with hepatitis C virus (HCV) in Germany. Long-term consequences are the development of liver cirrhosis and hepatocellular carcinoma. The aim of the study was to assess the costs for treating patients with chronic HCV in Germany.
  
  
  METHODS
  We conducted a retrospective multicenter observational study. The design was approved by an ethics committee, and patients were asked for their informed consent. Patients were grouped in four different health states. Healthcare utilization data were extracted from doctor files of six medical centers in Germany.
  
  
  RESULTS
  Data of 315 patients with chronic HCV were analyzed. The mean age was 49.4 years, 57.5% were male and 67.9% had a genotype 1 infection. The most common routes of transmission were injection drug use (39.0%) and infection through blood products (15.9%). The average total cost was €19 147 including ambulatory care and diagnostics (€1686), pharmaceuticals (€14 875), inpatient care (€1293), and sick leave (€1293). For patients in stable health states (mild and moderate HCV, compensated cirrhosis), costs did not differ significantly and were mainly influenced by antiviral treatment. For patients with decompensated cirrhosis, inpatient care accounted for the largest part of the costs.
  
  
  CONCLUSIONS
  Treatment of HCV patients involves high costs, mainly associated with the length of antiviral therapy. Viral eradication can prevent severe disease stages, which are associated with high costs. It is necessary to follow current guidelines and monitor patients closely to avoid unnecessary costs.
authors.affiliation: aInstitute of Epidemiology, Social Medicine and Health Systems Research bDepartment of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School cGerman Liver Foundation, Hannover dDepartment of Internal Medicine, Krankenhaus Nordwest eInstitute of Gastroenterology and Hepatology, University Hospital Frankfurt a.M., Frankfurt fDepartment of Internal Medicine, University Medical Centre Mannheim, Mannheim gCenter for Internal Medicine, Faculty of Medicine, University of Cologne, Cologne hCentre for Gastroenterology and Hepatology, Kiel iPractice for Gastroenterology, Herne, Germany.
authors.forename: Jona T
authors.initials: JT
authors.lastname: Stahmeyer
authors.forename: Siegbert
authors.initials: S
authors.lastname: Rossol
authors.forename: Florian
authors.initials: F
authors.lastname: Bert
authors.forename: Christoph
authors.initials: C
authors.lastname: Antoni
authors.forename: Münevver
authors.initials: M
authors.lastname: Demir
authors.forename: Holger
authors.initials: H
authors.lastname: Hinrichsen
authors.forename: Dietrich
authors.initials: D
authors.lastname: Hüppe
authors.forename: Gerlinde
authors.initials: G
authors.lastname: Teuber
authors.forename: Bianka
authors.initials: B
authors.lastname: Wiebner
authors.forename: Heiner
authors.initials: H
authors.lastname: Wedemeyer
authors.forename: Christian
authors.initials: C
authors.lastname: Krauth
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D017281:Cost of Illness; D004334:Drug Administration Schedule; D016527:Drug Costs / Q000706:statistics & numerical data; D005260:Female; D005858:Germany / Q000453:epidemiology; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006302:Health Services Research / Q000379:methods; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000191:economics* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D000998:Antiviral Agents