Chronic hepatitis C virus (HCV) disease burden and cost in... : Hepatology (original) (raw)

Viral Hepatitis

Razavi, Homie1,*,†; ElKhoury, Antoine C.2; Elbasha, Elamin2; Estes, Chris1; Pasini, Ken1; Poynard, Thierry3; Kumar, Ritesh2

1_Center for Disease Analysis, Louisville, CO_

2_Merck, Sharp, & Dohme Corp., Whitehouse Station, NJ_

3_Université Pierre et Marie Curie Liver Center, Paris, France_

*Center for Disease Analysis, 901 Front Street, Suite 291, Louisville, CO 80027

Email:[email protected]

Received 3 September 2012; Accepted 10 December 2012

View this article online atwileyonlinelibrary.com.

Potential conflict of interest: Authors 1Received funding for this project from Merck & Co. Inc.; 2Employee of Merck & Co. Inc.; 3Consulted with Merck, Roche, Vertex, and Gilead. Dr. ElKhoury owns stock in Merck.

†fax: 720-890-3817

Abstract

Hepatitis C virus (HCV) infection is a leading cause of cirrhosis, hepatocellular carcinoma, and liver transplantation. A better understanding of HCV disease progression and the associated cost can help the medical community manage HCV and develop treatment strategies in light of the emergence of several potent anti-HCV therapies. A system dynamic model with 36 cohorts was used to provide maximum flexibility and improved forecasting. New infections incidence of 16,020 (95% confidence interval, 13,510-19,510) was estimated in 2010. HCV viremic prevalence peaked in 1994 at 3.3 (2.8-4.0) million, but it is expected to decline by two-thirds by 2030. The prevalence of more advanced liver disease, however, is expected to increase, as well as the total cost associated with chronic HCV infection. Today, the total cost is estimated at 6.5(6.5 (6.5(4.3-$8.4) billion and it will peak in 2024 at 9.1(9.1 (9.1(6.4-$13.3) billion. The lifetime cost of an individual infected with HCV in 2011 was estimated at $64,490. However, this cost is significantly higher among individuals with a longer life expectancy. Conclusion: This analysis demonstrates that US HCV prevalence is in decline due to a lower incidence of infections. However, the prevalence of advanced liver disease will continue to increase as well as the corresponding healthcare costs. Lifetime healthcare costs for an HCV-infected person are significantly higher than for noninfected persons. In addition, it is possible to substantially reduce HCV infection through active management.