Modeling the Health and Economic Burden of Hepatitis C Virus in Switzerland
Chronic hepatitis C virus infection is a major cause of liver disease in Switzerland and carries a significant cost burden. Currently, only conservative strategies are in place to mitigate the burden of hepatitis C in Switzerland. This study expands on previously described modeling efforts to explor...
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| Published in: | PloS one Vol. 10; no. 6; p. e0125214 |
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| Main Authors: | , , , , , , , |
| Format: | Journal Article |
| Language: | English |
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24.06.2015
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| ISSN: | 1932-6203, 1932-6203 |
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| Abstract | Chronic hepatitis C virus infection is a major cause of liver disease in Switzerland and carries a significant cost burden. Currently, only conservative strategies are in place to mitigate the burden of hepatitis C in Switzerland. This study expands on previously described modeling efforts to explore the impact of: no treatment, and treatment to reduce HCC and mortality. Furthermore, the costs associated with untreated HCV were modeled.
Hepatitis C disease progression and mortality were modeled. Baseline historical assumptions were collected from the literature and expert interviews and strategies were developed to show the impact of different levels of intervention (improved drug cure rates, treatment and diagnosis) until 2030.
Under the historical standard of care, the number of advanced stage cases was projected to increase until 2030, at which point the annual economic burden of untreated viremic infections was projected to reach €96.8 (95% Uncertainty Interval: €36 - €232) million. Scenarios to reduce HCV liver-related mortality by 90% by 2030 required treatment of 4,190 ≥F2 or 3,200 ≥F3 patients annually by 2018 using antivirals with a 95% efficacy rate. Delaying the implementation of these scenarios by 2 or 5 years reduced the impact on mortality to 75% and 57%, respectively.
With today's treatment efficacy and uptake rates, hepatitis C disease burden is expected to increase through 2030. A substantial reduction in disease burden can be achieved by means of both higher efficacy drugs and increased treatment uptake. However, these efforts cannot be undertaken without a simultaneous effort to diagnose more infections. |
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| AbstractList | Background Chronic hepatitis C virus infection is a major cause of liver disease in Switzerland and carries a significant cost burden. Currently, only conservative strategies are in place to mitigate the burden of hepatitis C in Switzerland. This study expands on previously described modeling efforts to explore the impact of: no treatment, and treatment to reduce HCC and mortality. Furthermore, the costs associated with untreated HCV were modeled. Methods Hepatitis C disease progression and mortality were modeled. Baseline historical assumptions were collected from the literature and expert interviews and strategies were developed to show the impact of different levels of intervention (improved drug cure rates, treatment and diagnosis) until 2030. Results Under the historical standard of care, the number of advanced stage cases was projected to increase until 2030, at which point the annual economic burden of untreated viremic infections was projected to reach €96.8 (95% Uncertainty Interval: €36 – €232) million. Scenarios to reduce HCV liver-related mortality by 90% by 2030 required treatment of 4,190 ≥F2 or 3,200 ≥F3 patients annually by 2018 using antivirals with a 95% efficacy rate. Delaying the implementation of these scenarios by 2 or 5 years reduced the impact on mortality to 75% and 57%, respectively. Conclusions With today’s treatment efficacy and uptake rates, hepatitis C disease burden is expected to increase through 2030. A substantial reduction in disease burden can be achieved by means of both higher efficacy drugs and increased treatment uptake. However, these efforts cannot be undertaken without a simultaneous effort to diagnose more infections. Chronic hepatitis C virus infection is a major cause of liver disease in Switzerland and carries a significant cost burden. Currently, only conservative strategies are in place to mitigate the burden of hepatitis C in Switzerland. This study expands on previously described modeling efforts to explore the impact of: no treatment, and treatment to reduce HCC and mortality. Furthermore, the costs associated with untreated HCV were modeled.BACKGROUNDChronic hepatitis C virus infection is a major cause of liver disease in Switzerland and carries a significant cost burden. Currently, only conservative strategies are in place to mitigate the burden of hepatitis C in Switzerland. This study expands on previously described modeling efforts to explore the impact of: no treatment, and treatment to reduce HCC and mortality. Furthermore, the costs associated with untreated HCV were modeled.Hepatitis C disease progression and mortality were modeled. Baseline historical assumptions were collected from the literature and expert interviews and strategies were developed to show the impact of different levels of intervention (improved drug cure rates, treatment and diagnosis) until 2030.METHODSHepatitis C disease progression and mortality were modeled. Baseline historical assumptions were collected from the literature and expert interviews and strategies were developed to show the impact of different levels of intervention (improved drug cure rates, treatment and diagnosis) until 2030.Under the historical standard of care, the number of advanced stage cases was projected to increase until 2030, at which point the annual economic burden of untreated viremic infections was projected to reach €96.8 (95% Uncertainty Interval: €36 - €232) million. Scenarios to reduce HCV liver-related mortality by 90% by 2030 required treatment of 4,190 ≥F2 or 3,200 ≥F3 patients annually by 2018 using antivirals with a 95% efficacy rate. Delaying the implementation of these scenarios by 2 or 5 years reduced the impact on mortality to 75% and 57%, respectively.RESULTSUnder the historical standard of care, the number of advanced stage cases was projected to increase until 2030, at which point the annual economic burden of untreated viremic infections was projected to reach €96.8 (95% Uncertainty Interval: €36 - €232) million. Scenarios to reduce HCV liver-related mortality by 90% by 2030 required treatment of 4,190 ≥F2 or 3,200 ≥F3 patients annually by 2018 using antivirals with a 95% efficacy rate. Delaying the implementation of these scenarios by 2 or 5 years reduced the impact on mortality to 75% and 57%, respectively.With today's treatment efficacy and uptake rates, hepatitis C disease burden is expected to increase through 2030. A substantial reduction in disease burden can be achieved by means of both higher efficacy drugs and increased treatment uptake. However, these efforts cannot be undertaken without a simultaneous effort to diagnose more infections.CONCLUSIONSWith today's treatment efficacy and uptake rates, hepatitis C disease burden is expected to increase through 2030. A substantial reduction in disease burden can be achieved by means of both higher efficacy drugs and increased treatment uptake. However, these efforts cannot be undertaken without a simultaneous effort to diagnose more infections. BackgroundChronic hepatitis C virus infection is a major cause of liver disease in Switzerland and carries a significant cost burden. Currently, only conservative strategies are in place to mitigate the burden of hepatitis C in Switzerland. This study expands on previously described modeling efforts to explore the impact of: no treatment, and treatment to reduce HCC and mortality. Furthermore, the costs associated with untreated HCV were modeled.MethodsHepatitis C disease progression and mortality were modeled. Baseline historical assumptions were collected from the literature and expert interviews and strategies were developed to show the impact of different levels of intervention (improved drug cure rates, treatment and diagnosis) until 2030.ResultsUnder the historical standard of care, the number of advanced stage cases was projected to increase until 2030, at which point the annual economic burden of untreated viremic infections was projected to reach €96.8 (95% Uncertainty Interval: €36 - €232) million. Scenarios to reduce HCV liver-related mortality by 90% by 2030 required treatment of 4,190 ≥F2 or 3,200 ≥F3 patients annually by 2018 using antivirals with a 95% efficacy rate. Delaying the implementation of these scenarios by 2 or 5 years reduced the impact on mortality to 75% and 57%, respectively.ConclusionsWith today's treatment efficacy and uptake rates, hepatitis C disease burden is expected to increase through 2030. A substantial reduction in disease burden can be achieved by means of both higher efficacy drugs and increased treatment uptake. However, these efforts cannot be undertaken without a simultaneous effort to diagnose more infections. Chronic hepatitis C virus infection is a major cause of liver disease in Switzerland and carries a significant cost burden. Currently, only conservative strategies are in place to mitigate the burden of hepatitis C in Switzerland. This study expands on previously described modeling efforts to explore the impact of: no treatment, and treatment to reduce HCC and mortality. Furthermore, the costs associated with untreated HCV were modeled. Hepatitis C disease progression and mortality were modeled. Baseline historical assumptions were collected from the literature and expert interviews and strategies were developed to show the impact of different levels of intervention (improved drug cure rates, treatment and diagnosis) until 2030. Under the historical standard of care, the number of advanced stage cases was projected to increase until 2030, at which point the annual economic burden of untreated viremic infections was projected to reach €96.8 (95% Uncertainty Interval: €36 - €232) million. Scenarios to reduce HCV liver-related mortality by 90% by 2030 required treatment of 4,190 ≥F2 or 3,200 ≥F3 patients annually by 2018 using antivirals with a 95% efficacy rate. Delaying the implementation of these scenarios by 2 or 5 years reduced the impact on mortality to 75% and 57%, respectively. With today's treatment efficacy and uptake rates, hepatitis C disease burden is expected to increase through 2030. A substantial reduction in disease burden can be achieved by means of both higher efficacy drugs and increased treatment uptake. However, these efforts cannot be undertaken without a simultaneous effort to diagnose more infections. Background Chronic hepatitis C virus infection is a major cause of liver disease in Switzerland and carries a significant cost burden. Currently, only conservative strategies are in place to mitigate the burden of hepatitis C in Switzerland. This study expands on previously described modeling efforts to explore the impact of: no treatment, and treatment to reduce HCC and mortality. Furthermore, the costs associated with untreated HCV were modeled. Methods Hepatitis C disease progression and mortality were modeled. Baseline historical assumptions were collected from the literature and expert interviews and strategies were developed to show the impact of different levels of intervention (improved drug cure rates, treatment and diagnosis) until 2030. Results Under the historical standard of care, the number of advanced stage cases was projected to increase until 2030, at which point the annual economic burden of untreated viremic infections was projected to reach €96.8 (95% Uncertainty Interval: €36 – €232) million. Scenarios to reduce HCV liver-related mortality by 90% by 2030 required treatment of 4,190 ≥F2 or 3,200 ≥F3 patients annually by 2018 using antivirals with a 95% efficacy rate. Delaying the implementation of these scenarios by 2 or 5 years reduced the impact on mortality to 75% and 57%, respectively. Conclusions With today’s treatment efficacy and uptake rates, hepatitis C disease burden is expected to increase through 2030. A substantial reduction in disease burden can be achieved by means of both higher efficacy drugs and increased treatment uptake. However, these efforts cannot be undertaken without a simultaneous effort to diagnose more infections. |
| Author | Müllhaupt, Beat Blach, Sarah Razavi, Homie Semela, David Negro, Francesco Bruggmann, Philip Bihl, Florian Lavanchy, Daniel |
| AuthorAffiliation | 2 Arud Centres for Addiction Medicine, Zürich, Switzerland 7 Divisions of Gastroenterology and Hepatology and of Clinical Pathology, University Hospital, Genève, Switzerland National Taiwan University Hospital, TAIWAN 3 Gastroenterology Department, Ospedale Cantonale, Bellinzona, Switzerland 1 Swiss HPB (Hepato-Pancreato-Biliary) Center and Department of Gastroenterology and Hepatology, University Hospital Zürich, Zürich, Switzerland 4 Center for Disease Analysis (CDA), Louisville, Colorado, United States of America 5 Consultant, Ruelle des Chataigniers 1, CH-1026 Denges VD, Switzerland 6 Division of Gastroenterology & Hepatology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland |
| AuthorAffiliation_xml | – name: 4 Center for Disease Analysis (CDA), Louisville, Colorado, United States of America – name: 1 Swiss HPB (Hepato-Pancreato-Biliary) Center and Department of Gastroenterology and Hepatology, University Hospital Zürich, Zürich, Switzerland – name: 3 Gastroenterology Department, Ospedale Cantonale, Bellinzona, Switzerland – name: National Taiwan University Hospital, TAIWAN – name: 2 Arud Centres for Addiction Medicine, Zürich, Switzerland – name: 5 Consultant, Ruelle des Chataigniers 1, CH-1026 Denges VD, Switzerland – name: 6 Division of Gastroenterology & Hepatology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland – name: 7 Divisions of Gastroenterology and Hepatology and of Clinical Pathology, University Hospital, Genève, Switzerland |
| Author_xml | – sequence: 1 givenname: Beat surname: Müllhaupt fullname: Müllhaupt, Beat – sequence: 2 givenname: Philip surname: Bruggmann fullname: Bruggmann, Philip – sequence: 3 givenname: Florian surname: Bihl fullname: Bihl, Florian – sequence: 4 givenname: Sarah surname: Blach fullname: Blach, Sarah – sequence: 5 givenname: Daniel surname: Lavanchy fullname: Lavanchy, Daniel – sequence: 6 givenname: Homie surname: Razavi fullname: Razavi, Homie – sequence: 7 givenname: David surname: Semela fullname: Semela, David – sequence: 8 givenname: Francesco surname: Negro fullname: Negro, Francesco |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/26107467$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_1016_j_jhep_2016_02_030 crossref_primary_10_1016_j_jval_2017_10_005 crossref_primary_10_1016_j_jhep_2017_10_010 crossref_primary_10_1186_s12961_022_00824_3 crossref_primary_10_3390_jcm10194562 crossref_primary_10_1371_journal_pone_0155464 crossref_primary_10_1371_journal_pone_0272518 crossref_primary_10_1007_s12072_017_9820_3 crossref_primary_10_1111_liv_15111 crossref_primary_10_1111_jvh_12803 crossref_primary_10_1001_jamanetworkopen_2020_4192 crossref_primary_10_1016_j_cld_2017_03_012 crossref_primary_10_1080_17512433_2018_1447923 crossref_primary_10_1111_jvh_13005 crossref_primary_10_1111_jvh_12535 crossref_primary_10_1017_S0950268816001722 crossref_primary_10_1371_journal_pone_0209374 crossref_primary_10_1111_jvh_13892 |
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| Copyright | 2015 Müllhaupt et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 2015 Müllhaupt et al 2015 Müllhaupt et al |
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| DOI | 10.1371/journal.pone.0125214 |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Conceived and designed the experiments: BM PB FB SB DL HR DS FN. Performed the experiments: BM PB FB SB DL HR DS FN. Analyzed the data: BM PB FB SB DL HR DS FN. Contributed reagents/materials/analysis tools: BM PB FB SB DL HR DS FN. Wrote the paper: BM PB FB SB DL HR DS FN. Competing Interests: Beat Müllhaupt has served as an advisory board member for Roche, MSD, Janssen Therapeutics, AbbVie, Boehringer Ingelheim, Gilead and BMS; as a consultant for Gilead and AbbVie; and has received research grants from Roche and Gilead. Philip Bruggmann has served as advisor and speaker for, and has received project and research grants from Roche, MSD, Janssen, AbbVie, Gilead, Viif and BMS. Sarah Blach and Homie Razavi are employees of the Center for Disease Analysis (CDA), Louisville, Colorado, USA. David Semela has served as a consultant for Gilead, an advisor for Roche, MSD, Gilead, Novartis, Janssen and Boehringer Ingelheim and has received an unrestricted research grant from Roche. Francesco Negro has served as advisor for MSD, Gilead, Novartis, Bristol Myers Squibb, AbbVie and Janssen and has received unrestricted research grants from Roche and Gilead. Florian Bihl and Daniel Lavanchy have no conflicts of interest to declare. As part of this project, none of the authors were part of any activities related to patents, product development or marketed products. The funding of this project by Gilead does not alter the authors’ adherence to PLOS ONE policies on sharing data and materials. |
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| Title | Modeling the Health and Economic Burden of Hepatitis C Virus in Switzerland |
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