Merck & Co., Inc., WP 97-A423, 770 Sumneytown Pike, West Point, PA 19486, USA.
Dig Dis Sci. 2012 Nov;57(11):2995-3003. doi: 10.1007/s10620-012-2233-1. Epub 2012 Jun 5.
Hepatitis C virus (HCV) infection is widespread and associated with high economic costs and reduced quality of life, but the impact of untreated HCV infection on patient outcome is not well understood.
To estimate the impact of untreated HCV infection on work productivity, daily activity, healthcare use, economic costs, and health-related quality of life (HRQoL).
Respondents to the 2010 US National Health and Wellness Survey (n = 75,000) reporting physician diagnosis of HCV infection but not current or previous treatment (patients) were matched to respondents without HCV infection (controls) by use of propensity scores. Those reporting infection with hepatitis B virus (HBV) or human immunodeficiency virus (HIV) were excluded. Self-reported work impairment, activity impairment, healthcare resource use, and HRQoL were compared between patients and controls. Indirect and direct costs were estimated.
A total of 306 patients met inclusion criteria. Patients were more impaired at work than controls, with overall work impairment of 26 % versus 15 %, respectively (P < 0.001), mostly because of presenteeism in both groups. Annual productivity losses were estimated at $10,316 per employed patient compared with $5,469 per control (P < 0.001). Patients used more healthcare, with all-cause healthcare costs estimated at $22,818 per patient annually, compared with $15,362 per control (P < 0.001). HRQoL and activity impairment were also worse among patients than controls.
Untreated HCV infection is associated with substantial economic costs to society, through loss of productivity and increased use of healthcare resources, and with impaired well-being of the patient.
丙型肝炎病毒(HCV)感染广泛存在,并与高昂的经济成本和降低的生活质量相关,但未经治疗的 HCV 感染对患者结局的影响尚未被充分认识。
评估未经治疗的 HCV 感染对工作生产力、日常活动、医疗保健利用、经济成本和健康相关生活质量(HRQoL)的影响。
2010 年美国全国健康和健康调查(n=75000)的应答者报告有医生诊断的 HCV 感染但未进行当前或既往治疗(患者),并使用倾向评分与无 HCV 感染的应答者(对照者)进行匹配。排除同时感染乙型肝炎病毒(HBV)或人类免疫缺陷病毒(HIV)的应答者。比较患者和对照者报告的工作受损、活动受限、医疗保健资源利用和 HRQoL。估计了间接和直接成本。
共有 306 名患者符合纳入标准。患者的工作受损程度高于对照者,总体工作受损率分别为 26%和 15%(P<0.001),这主要是因为两组都存在出勤工作能力受损。与每名在职患者每年 10316 美元的估计生产力损失相比,每名对照者每年 5469 美元(P<0.001)。患者的医疗保健利用更多,每名患者的全因医疗保健费用估计为每年 22818 美元,而每名对照者为 15362 美元(P<0.001)。与对照者相比,患者的 HRQoL 和活动受限也更差。
未经治疗的 HCV 感染会导致生产力下降和医疗保健资源利用增加,给社会带来巨大的经济成本,并对患者的幸福感产生负面影响。