Younossi Z M, Chan H L Y, Dan Y Y, Lee M H, Lim Y-S, Kruger E, Tan S C
Center for Liver Diseases, Department of Medicine, Inova Fairfax Hospital, Falls Church, VA, USA.
Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, USA.
J Viral Hepat. 2018 Mar;25(3):228-235. doi: 10.1111/jvh.12808. Epub 2017 Nov 29.
Chronic, untreated hepatitis C virus (HCV) infection is associated with a poor clinical prognosis and a detrimental impact on patients' lives, including on work productivity. To estimate the value of productivity losses due to genotype 1 (GT1) HCV infection in Hong Kong, Singapore, South Korea and Taiwan and to estimate the potential productivity gains associated with treating patients with ledipasvir/sofosbuvir (LDV/SOF) therapy, an economic model was developed with a time horizon of 1 year. Hepatitis C virus patients entered the model at 12 weeks post-treatment, having achieved or not achieved sustained virological response (SVR). Absenteeism and presenteeism rates were taken from a pooled analysis of data from the ION 1-3 studies. These rates were converted into hours of lost productivity, multiplied by the average wage and applied to the total employed, adult GT1 population in each country. Results were compared assuming no treatment, and assuming all patients were treated with LDV/SOF. Total productivity losses due to untreated HCV were: $11.3 million, $17.1 m, $146.0 m and $349.1 m in Hong Kong, Singapore, South Korea and Taiwan. LDV/SOF treatment resulted in economic gains of $4.5 m, $6.8 m, $58.7 m and $138 m, respectively. These gains were due to reduced presenteeism. The results were sensitive to changes in the prevalence of HCV and the average wage. In conclusion, productivity losses due to untreated HCV infection represent a substantial economic burden. By instituting universal HCV treatment with LDV/SOF (or other therapies with high SVR rates), productivity gains can be achieved.
慢性丙型肝炎病毒（HCV）感染若未经治疗，临床预后较差，会对患者生活产生不利影响，包括影响工作效率。为评估香港、新加坡、韩国和台湾地区因基因1型（GT1）HCV感染导致的生产力损失价值，并估计使用来迪派韦/索磷布韦（LDV/SOF）治疗患者可能带来的生产力提升，开发了一个时间跨度为1年的经济模型。HCV患者在治疗后12周进入模型，此时已实现或未实现持续病毒学应答（SVR）。旷工率和出勤但低效工作率取自ION 1 - 3研究的汇总数据分析。这些比率被转换为生产力损失小时数，乘以平均工资，并应用于每个国家就业的成年GT1人群总数。比较了假设不进行治疗和假设所有患者均接受LDV/SOF治疗的结果。在香港、新加坡、韩国和台湾地区，未经治疗的HCV导致的总生产力损失分别为：1130万美元、1710万美元、1.46亿美元和3.491亿美元。LDV/SOF治疗分别带来了450万美元、680万美元、5870万美元和1.38亿美元的经济效益。这些收益归因于出勤但低效工作情况的减少。结果对HCV患病率和平均工资的变化敏感。总之，未经治疗的HCV感染导致的生产力损失是一项巨大的经济负担。通过采用LDV/SOF进行普遍的HCV治疗（或其他具有高SVR率的疗法），可以实现生产力提升。
