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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Vydané v:PloS one Ročník 10; číslo 6; s. e0125214
Hlavní autori: Müllhaupt, Beat, Bruggmann, Philip, Bihl, Florian, Blach, Sarah, Lavanchy, Daniel, Razavi, Homie, Semela, David, Negro, Francesco
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: United States Public Library of Science 24.06.2015
Public Library of Science (PLoS)
Predmet:
Adolescent
Adult
Antiviral agents
Antiviral Agents - therapeutic use
Biopsy
Chronic infection
Economic models
Economics
Effectiveness
Estimates
Female
Gastroenterology
Hepacivirus - pathogenicity
Hepatitis
Hepatitis C
Hepatitis C, Chronic - economics
Hepatitis C, Chronic - epidemiology
Hepatitis C, Chronic - therapy
Hepatology
Hospitals
Humans
Infections
Liver
Liver cirrhosis
Liver Cirrhosis - economics
Liver Cirrhosis - epidemiology
Liver Cirrhosis - therapy
Liver diseases
Liver Transplantation
Liver transplants
Male
Medical treatment
Middle Aged
Modelling
Mortality
Population
Primary care
Public health
Switzerland
Systematic review
Viruses
Switzerland
United States > US
Colorado
ISSN:1932-6203, 1932-6203
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Popis
Shrnutí: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.
Bibliografia:ObjectType-Article-1
SourceType-Scholarly Journals-1
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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.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0125214