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Costs of Treatment, Follow-Up, and Complications of Chronic Hepatitis B and Hepatitis C Infections

Year 2013, Volume: 2013 Issue: 4, 375 - 381, 01.04.2013
https://doi.org/10.5152/balkanmedj.2013.7547

Abstract

Background: Few studies have addressed the indirect costs of chronic hepatitis B and C, and none has assessed the real costs of these conditions, including indirect costs caused by loss of work, in Turkey. Aims: This study therefore analysed the costs of treatment, follow-up, and complications of chronic hepatitis B and hepatitis C infections to the community. Study design: Cross-sectional study. Methods: This study analysed patients with chronic hepatitis B and hepatitis C treated at Pamukkale University Hospital Infectious Diseases and Clinical Microbiology Clinic, Denizli, Turkey between June 2009 and June 2010. Costs of antiviral treatment and follow-up were calculated from patients' medical records, and indirect costs were analysed from questionnaires completed by patients. Results: Data were analysed for 284 patients with chronic viral hepatitis. Indirect, hospital, treatment and total expenses were significantly higher for patients with chronic hepatitis B than for inactive hepatitis B virus carriers and patients with chronic hepatitis C. Hospital and total expenses of patients with complications were significantly higher than for patients with chronic hepatitis C. Hospital and total expenses were significantly higher for patients with than for individuals without cirrhosis. Indirect, hospital, treatment and total costs of patients were significantly higher for patients receiving combination therapy than monotherapy. Conclusion: Reducing the costs to society of chronic hepatitis requires the development of protection and screening programs. Turkish Başlık: Kronik Hepatit B ve Kronik Hepatit C Hastalarının Tedavi, Takip ve Komplikasyonlarının Maliyeti Anahtar Kelimeler:Maliyet, kronik hepatit B, kronik hepatit C Arkaplan: Kronik hepatit B ve C hastalıklarının dolaylı maliyetlerini inceleyen birkaç çalışma bulunmaktadır ancak işgücü kaybının yol açtığı dolaylı maliyetleri de içeren gerçek maliyetleri ortaya koyan bir çalışma Türkiye'de yapılmamıştır. Amaç: Bu çalışmada kronik hepatit B ve kronik hepatit C infeksiyonlarının tedavi, takip ve komplikasyonlarının topluma maliyeti incelenmiştir. Çalışma Tasarımı: Kesitsel çalışma Yöntemler: Bu çalışma Pamukkale Üniversitesi Hastanesi İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Kliniği, Denizli, Türkiye tarafından Haziran 2009- Haziran 2010 tarihleri arasında tedavi edilen kronik hepatit B ve hepatit C hastalarını incelemektedir. Antiviral tedavi ve takip maliyetleri hastaların tıbbi kayıtlarından hesaplanmıştır, ve dolaylı maliyetler hastalar tarafından doldurulan anketlerden hesaplanmıştır. Bulgular: Kronik viral hepatitli 284 hastanın verileri incelenmiştir. Kronik hepatit B hastalarının dolaylı, hastane, tedavi, ve toplam maliyetleri inaktif hepatit B taşıyıcıları ve kronik hepatit C hastalarından istatistiksel olarak anlamlı yüksek bulunmuştur. Komplikasyonlu hastaların hastane ve toplam maliyetleri kronik hepatit C hastalarından istatistiksel olarak anlamlı yüksek bulunmuştur. Sirozlu hastaların hastane ve toplam maliyetleri sirozu olmayan hastalardan istatistiksel olarak anlamlı yüksek bulunmuştur. Kombinasyon tedavisi alan hastaların dolaylı, hastane, tedavi ve toplam maliyetleri monoterapi alan hastalardan istatistiksel olarak anlamlı yüksek bulunmuştur. Sonuç: Kronik hepatitlerin topluma maliyetlerini azaltmak için korunma ve tarama programlarının geliştirilmesi gerekmektedir.

References

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  • Yang BM, Paik SW, Hahn OS, Yi DH, Choi MS, Payne S. Economic evaluation of the societal costs of hepatitis B in South Korea. J Gastroenterol Hepatol 2001;16:301-8. [CrossRef]
  • Kim WR, Poterucha JJ, Hermans JE, Therneau TM, Dickson ER, Evans RW, et al. Cost-effectiveness of 6 and 12 months of interferon-alpha therapy for chronic hepatitis C. Ann Intern Med 1997;127:866-74. [CrossRef]
  • Lok ASF, McMahon BJ. Chronic hepatitis B: update 2009. Hepatology 2009;50:661-2. [CrossRef]
  • European Association for the Study of the Liver. EASL Clinical Practice Guidelines: management of chronic hepatitis B. J Hepatol 2009;50:227-42. [CrossRef]
  • Piratvisuth T. Reviews for APASL guidelines: Immunomodulator therapy of chronic hepatitis B. Hepatol Int 2008;2:140-6. [CrossRef]
  • Lok AS, McMahon BJ; Practice Guidelines Committee, American Association for the Study of Liver Diseases (AASLD). Chronic hepatitis B: update of recommendations. Hepatology 2004;39:857-61. [CrossRef] McMahon BJ. Epidemiology and natural history of hepatitis B. Semin Liver Dis 2005;25 Suppl 1: 3-8. [CrossRef]
  • Lavanchy D. Hepatitis B virus epidemiology, diseases burden, treatment, and current and emerging prevention and control measures. J Viral Hepat 2004;11:97-107. [CrossRef]
  • Gold MR, Siegel JE, Russell LB, Weinstein MC. Cost-effectiveness in health and medicine. New York: Oxford University Pres 1996.
  • Wong JB. Hepatitis C: cost of illness and considerations for the economic evaluation of antiviral therapies. Pharmacoeconomics 2006;24:661-72. [CrossRef]
  • Faissol DM, Griffin PM, Swann JL. Bias in Markov models of diseases. Math Biosci 2009;220:143-56. [CrossRef]
  • Li SC, Ong SC, Lim SG, Yeoh KG, Kwong KS, Lee V, et al. A cost comparison of management of chronic hepatitis B and its associated complications in Hong Kong and Singapore. J Clin Gastroenterol 2004;38:S136-43. [CrossRef]
  • Lacey LF, Gane E. The cost-effectiveness of long-term antiviral therapy in the management of HBeAg-positive and HBeAg-negative chronic hepatitis B in Singapore. J Viral Hepat 2007;14:751-66. [CrossRef]
  • Sullivan SD, Veenstra DL, Chen PJ, Chang TT, Chuang WL, Tsai C, et al. Cost- effectiveness of peginterferon alpha-2a compared to lamivudine treatment patients with hepatitis B e antigen positive chronic hepatitis B in Taiwan. J Gastroenterol Hepatol 2007;22:1494-9. [CrossRef]
  • Vanagas G, Padaiga Z, Mickeviciene A. Cost-effectiveness and cost-utility of the treatment of chronic hepatitis B with peginterferon alfa-2a, interferon alfa, and lamivudine in Lithuania. Medicana (Kaunas) 2010;46:835-42.
  • Buti M, Brosa M, Casado MA, Rueda M, Esteban R. Modeling the cost-effectiveness of different oral antiviral therapies in patients with chronic hepatitis B. J Hepatol 2009;51:640-6. [CrossRef]
  • Su J, Brook RA, Kleinman NL, Corey-Lisle P. The impact of hepatitis C virus infection on work absence, productivity, and healthcare benefit costs. Hepatology 2010;52:436-42 [CrossRef]
  • Stein K, Rosenberg W, Wong J. Cost effectiveness of combination therapy for hepatitis C: a decision analytic model. Gut 2002;50:253-8. [CrossRef]
  • Salomon JA, Weinstein MC, Hammitt JK, Goldie SJ. Cost-effectiveness of treatment for chronic hepatitis C infection in an evolving patient population. JAMA 2003;290:228-37. [CrossRef]

Costs of Treatment, Follow-Up, and Complications of Chronic Hepatitis B and Hepatitis C Infections

Year 2013, Volume: 2013 Issue: 4, 375 - 381, 01.04.2013
https://doi.org/10.5152/balkanmedj.2013.7547

Abstract

References

  • Chen CJ, Yang HI, Su J, et al. Serial monitoring of viral load and serum alanine aminotransferase level and the risk of hepatocellular carcinoma (HCC): R.E.V.E.A.L.- HBV study update. In: 43rd Annual Meeting of the European Association for the Study of the Liver (EASL 2008); 2008 April 23- 27; Milan, Italy.
  • Yang BM, Paik SW, Hahn OS, Yi DH, Choi MS, Payne S. Economic evaluation of the societal costs of hepatitis B in South Korea. J Gastroenterol Hepatol 2001;16:301-8. [CrossRef]
  • Kim WR, Poterucha JJ, Hermans JE, Therneau TM, Dickson ER, Evans RW, et al. Cost-effectiveness of 6 and 12 months of interferon-alpha therapy for chronic hepatitis C. Ann Intern Med 1997;127:866-74. [CrossRef]
  • Lok ASF, McMahon BJ. Chronic hepatitis B: update 2009. Hepatology 2009;50:661-2. [CrossRef]
  • European Association for the Study of the Liver. EASL Clinical Practice Guidelines: management of chronic hepatitis B. J Hepatol 2009;50:227-42. [CrossRef]
  • Piratvisuth T. Reviews for APASL guidelines: Immunomodulator therapy of chronic hepatitis B. Hepatol Int 2008;2:140-6. [CrossRef]
  • Lok AS, McMahon BJ; Practice Guidelines Committee, American Association for the Study of Liver Diseases (AASLD). Chronic hepatitis B: update of recommendations. Hepatology 2004;39:857-61. [CrossRef] McMahon BJ. Epidemiology and natural history of hepatitis B. Semin Liver Dis 2005;25 Suppl 1: 3-8. [CrossRef]
  • Lavanchy D. Hepatitis B virus epidemiology, diseases burden, treatment, and current and emerging prevention and control measures. J Viral Hepat 2004;11:97-107. [CrossRef]
  • Gold MR, Siegel JE, Russell LB, Weinstein MC. Cost-effectiveness in health and medicine. New York: Oxford University Pres 1996.
  • Wong JB. Hepatitis C: cost of illness and considerations for the economic evaluation of antiviral therapies. Pharmacoeconomics 2006;24:661-72. [CrossRef]
  • Faissol DM, Griffin PM, Swann JL. Bias in Markov models of diseases. Math Biosci 2009;220:143-56. [CrossRef]
  • Li SC, Ong SC, Lim SG, Yeoh KG, Kwong KS, Lee V, et al. A cost comparison of management of chronic hepatitis B and its associated complications in Hong Kong and Singapore. J Clin Gastroenterol 2004;38:S136-43. [CrossRef]
  • Lacey LF, Gane E. The cost-effectiveness of long-term antiviral therapy in the management of HBeAg-positive and HBeAg-negative chronic hepatitis B in Singapore. J Viral Hepat 2007;14:751-66. [CrossRef]
  • Sullivan SD, Veenstra DL, Chen PJ, Chang TT, Chuang WL, Tsai C, et al. Cost- effectiveness of peginterferon alpha-2a compared to lamivudine treatment patients with hepatitis B e antigen positive chronic hepatitis B in Taiwan. J Gastroenterol Hepatol 2007;22:1494-9. [CrossRef]
  • Vanagas G, Padaiga Z, Mickeviciene A. Cost-effectiveness and cost-utility of the treatment of chronic hepatitis B with peginterferon alfa-2a, interferon alfa, and lamivudine in Lithuania. Medicana (Kaunas) 2010;46:835-42.
  • Buti M, Brosa M, Casado MA, Rueda M, Esteban R. Modeling the cost-effectiveness of different oral antiviral therapies in patients with chronic hepatitis B. J Hepatol 2009;51:640-6. [CrossRef]
  • Su J, Brook RA, Kleinman NL, Corey-Lisle P. The impact of hepatitis C virus infection on work absence, productivity, and healthcare benefit costs. Hepatology 2010;52:436-42 [CrossRef]
  • Stein K, Rosenberg W, Wong J. Cost effectiveness of combination therapy for hepatitis C: a decision analytic model. Gut 2002;50:253-8. [CrossRef]
  • Salomon JA, Weinstein MC, Hammitt JK, Goldie SJ. Cost-effectiveness of treatment for chronic hepatitis C infection in an evolving patient population. JAMA 2003;290:228-37. [CrossRef]
There are 19 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Articles
Authors

Fatma Banu Karahasanoğlu This is me

Ali Asan This is me

Suzan Sacar This is me

Hüseyin Turgut This is me

Publication Date April 1, 2013
Published in Issue Year 2013 Volume: 2013 Issue: 4

Cite

APA Karahasanoğlu, F. B., Asan, A., Sacar, S., Turgut, H. (2013). Costs of Treatment, Follow-Up, and Complications of Chronic Hepatitis B and Hepatitis C Infections. Balkan Medical Journal, 2013(4), 375-381. https://doi.org/10.5152/balkanmedj.2013.7547
AMA Karahasanoğlu FB, Asan A, Sacar S, Turgut H. Costs of Treatment, Follow-Up, and Complications of Chronic Hepatitis B and Hepatitis C Infections. Balkan Medical Journal. April 2013;2013(4):375-381. doi:10.5152/balkanmedj.2013.7547
Chicago Karahasanoğlu, Fatma Banu, Ali Asan, Suzan Sacar, and Hüseyin Turgut. “Costs of Treatment, Follow-Up, and Complications of Chronic Hepatitis B and Hepatitis C Infections”. Balkan Medical Journal 2013, no. 4 (April 2013): 375-81. https://doi.org/10.5152/balkanmedj.2013.7547.
EndNote Karahasanoğlu FB, Asan A, Sacar S, Turgut H (April 1, 2013) Costs of Treatment, Follow-Up, and Complications of Chronic Hepatitis B and Hepatitis C Infections. Balkan Medical Journal 2013 4 375–381.
IEEE F. B. Karahasanoğlu, A. Asan, S. Sacar, and H. Turgut, “Costs of Treatment, Follow-Up, and Complications of Chronic Hepatitis B and Hepatitis C Infections”, Balkan Medical Journal, vol. 2013, no. 4, pp. 375–381, 2013, doi: 10.5152/balkanmedj.2013.7547.
ISNAD Karahasanoğlu, Fatma Banu et al. “Costs of Treatment, Follow-Up, and Complications of Chronic Hepatitis B and Hepatitis C Infections”. Balkan Medical Journal 2013/4 (April 2013), 375-381. https://doi.org/10.5152/balkanmedj.2013.7547.
JAMA Karahasanoğlu FB, Asan A, Sacar S, Turgut H. Costs of Treatment, Follow-Up, and Complications of Chronic Hepatitis B and Hepatitis C Infections. Balkan Medical Journal. 2013;2013:375–381.
MLA Karahasanoğlu, Fatma Banu et al. “Costs of Treatment, Follow-Up, and Complications of Chronic Hepatitis B and Hepatitis C Infections”. Balkan Medical Journal, vol. 2013, no. 4, 2013, pp. 375-81, doi:10.5152/balkanmedj.2013.7547.
Vancouver Karahasanoğlu FB, Asan A, Sacar S, Turgut H. Costs of Treatment, Follow-Up, and Complications of Chronic Hepatitis B and Hepatitis C Infections. Balkan Medical Journal. 2013;2013(4):375-81.