Quan­ti­fy­ing the Clin­i­cal, Eco­nomic and Qual­ity of Life Impacts of the Deci­sion to Treat and Treat­ment at Early Stages of Hepati­tis C (HCV) Genotype-1 in Louisiana: a Cost-Effectiveness of Analysis

 Dwana J. Green, MPH

It is esti­mated that 3 to 5 mil­lion indi­vid­u­als in the U.S. are chron­i­cally infected with HCV.  More than 12,000 deaths occur annu­ally in the U.S. as a result of HCV-related liver dis­ease.  The cost of treat­ment for indi­vid­u­als with HCV genotype-1 is approx­i­mately $100,000. (Razavi, 2013) The high cost of treat­ment has led to fears that many who could ben­e­fit from treat­ment will not receive it con­sid­er­ing many with HCV are unin­sured or have Medicaid.

Of the 50,000 peo­ple in Louisiana pro­jected to develop chronic HCV, 10,000 will progress to cir­rho­sis which has a 25% fatal­ity rate.  About 3,000 are can­di­dates for a liver trans­plant which it esti­mated to cost $900 mil­lion.  (Louisiana Office of Pub­lic Health — Infec­tious Dis­ease Sec­tion, 2011)

This project eval­u­ates the life expectancy, cost and cost-effectiveness of treat­ing HCV.  A deci­sion tree and Markov model will sim­u­late pro­gres­sion through the var­i­ous states of health involved in pro­gres­sive HCV dis­ease, includ­ing death.

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