Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea.
Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea.
Gut Liver. 2017 Nov 15;11(6):835-842. doi: 10.5009/gnl17034.
BACKGROUND/AIMS: The introduction of direct-acting antivirals (DAA) in 2013 revolutionized hepatitis C virus (HCV) treatment, offering a cure rate >90%. However, this therapy is expensive, and estimations of the number of chronic HCV-infected (CHC) patients and their treatment costs pre-2013 are therefore essential for creating policies and expanding drug access. Herein, we aimed to investigate the number of HCV-related liver disease patients, their healthcare utilization, their annual direct medical costs, and the interferon-based antiviral treatment rates and costs from 2009 to 2013 in South Korea.
The National Health Insurance database was reviewed, and patients diagnosed with CHC from 2009 to 2013 were extracted. Data regarding detailed healthcare utilization, prescribed drugs, and direct medical costs were obtained. For annual direct healthcare cost calculations, a prevalence-based approach was used.
Overall, 181,768 CHC patients were identified. In 2013, the annual per-patient costs for chronic hepatitis, liver cirrhosis, hepatocellular carcinoma, and the first year post-liver transplant were 895, 1,873, 6,945, and 67,359 United States dollars, respectively. Interferon-based antiviral therapeutics were prescribed to 25,223 patients (13.9%).
Healthcare costs have increased remarkably with increasing liver disease severity. Thus, efforts to stop disease progression are needed. Moreover, the low rate of interferon-based therapy indicates an unmet need for DAA.
背景/目的：2013 年直接作用抗病毒药物（DAA）的引入彻底改变了丙型肝炎病毒（HCV）的治疗方法，治愈率超过 90%。然而，这种治疗方法费用昂贵，因此，对 2013 年前慢性 HCV 感染（CHC）患者的数量及其治疗费用进行评估对于制定政策和扩大药物可及性至关重要。在此，我们旨在调查 HCV 相关肝病患者的数量、他们的医疗保健利用情况、他们的年度直接医疗费用以及 2009 年至 2013 年韩国基于干扰素的抗病毒治疗率和费用。
审查了国家健康保险数据库，并提取了 2009 年至 2013 年被诊断为 CHC 的患者。获得了有关详细医疗保健利用、处方药物和直接医疗费用的数据。为了计算年度直接医疗保健成本，采用了基于患病率的方法。
总体而言，确定了 181768 例 CHC 患者。2013 年，慢性肝炎、肝硬化、肝细胞癌和肝移植后第一年的每位患者的年度医疗费用分别为 895、1873、6945 和 67359 美元。为 25223 名患者（13.9%）开了基于干扰素的抗病毒治疗药物。
随着肝病严重程度的增加，医疗保健费用显著增加。因此，需要努力阻止疾病的进展。此外，基于干扰素的治疗率低表明 DAA 的需求未得到满足。
