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Abstract
Introduction Hepatitis C genotype 1 (GT1) is most common in the United Kingdom (UK). Chronic hepatitis C (CHC) related work impairment, manifested as increased presenteeism and absenteeism presents an economic burden for both employers and society. Treatment with Ledipasvir/Sofosbuvir (LDV/SOF) demonstrates high efficacy, excellent tolerability profiles and significant QOL improvement. An economic model was created to evaluate the impact of LDV/SOF treatment vsno treatment for patients with GT1 HCV infection on work productivity in UK.
Method This cost-analysis model integrates epidemiologic and economic data to estimate CHC GT1 patients’ productivity impairment per annum across two scenarios: treatment with LDV/SOF vsno treatment. We estimated the total number of CHC GT1 patients in the workforce in the British population using employment rate for HCV patients, GT1 prevalence (45.0%) and vireamic prevalence (0.4%). Absenteeism and presenteeism rates were obtained from ION trials; rates were assumed to remain unchanged from baseline in patients not achieving SVR. The cost of total work hours per patient was calculated using national working hours per year and labour costs. Sensitivity analyses were performed to assess impact of a 20% reduction in labour costs and of differing employment rates by fibrosis stage observed for the European ION trials participants.
Results Treating British GT1 patients with LDV/SOF could result in estimated productivity gains of £17M annually (£202.6 per patient) (Table 1). Results from the sensitivity analyses using reduced labour costs among HCV patients showed estimated productivity gains of £13.6M (£162.1 per patient) (Table 1). Using the differential employment rates by cirrhotic status showed that although patient level gains are higher in cirrhotic (£332.9) than in non-cirrhotic patients (£238.5), overall population level gains are higher for non-cirrhotic patients (£16.8M million pounds vs£4.6M), as non-cirrhotic patients represent 84% of the GT1 CHC population.
Conclusion Treatment with LDV/SOF for GT1 CHC patients could provide substantial economic gains associated with work productivity increases in UK, both at patient and population level, which would need to be offset against treatment cost.
Disclosure of interest W. Rosenberg Consultant for: Eisai, GSK, Speaker Bureau of: Gilead, Janssen, Conflict with: Janssen, MSD, Gilead, A. Brown Consultant for: Abbvie, BMS, Gilead, Janssen, Merck, Speaker Bureau of: Abbvie, BMS, Gilead, Janssen, Merck, A. Srivastava: None Declared, N. Smith: None Declared, M. Stepanova: None Declared, Z. Younossi Consultant for: Gilead, BMS, Intercept, Abbvie, Salix, Merck, GSK.
