Evidence map›Paper›PMID 31030359›Full record

Observational studyApplied health economics and health policy2019

The Costs of Hepatitis C by Liver Disease Stage: Estimates from the Veterans Health Administration.

Risha Gidwani-Marszowski, Douglas K Owens, Jeanie Lo, Jeremy D Goldhaber-Fiebert, Steven M Asch, Paul G Barnett

Open access · greenAbstract readObservational Study
In one paragraph

Observational study in Applied health economics and health policy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.3field-weighted citation impact, top 42% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 4 citations in OpenAlex.

  1. Review
  2. Review
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Risha Gidwani-MarszowskiVA Health Economics Resource Center, VA Palo Alto Health Care System, 795 Willow Rd. (152 MPD), Menlo Park, CA, 94025, USA. risha.gidwani@va.gov.ORCID http://orcid.org/0000-0002-3548-2332
Douglas K OwensVA Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA, USA.
Jeanie LoVA Health Economics Resource Center, VA Palo Alto Health Care System, 795 Willow Rd. (152 MPD), Menlo Park, CA, 94025, USA.
Jeremy D Goldhaber-FiebertCenter for Primary Care and Outcomes Research/Center for Health Policy, Department of Medicine, Stanford University, Stanford, CA, USA.
Steven M AschVA Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA, USA.
Paul G BarnettVA Health Economics Resource Center, VA Palo Alto Health Care System, 795 Willow Rd. (152 MPD), Menlo Park, CA, 94025, USA.
VA Palo Alto Health Care System · USStanford University · US

Funding

Cost-effective chronic disease prevention in developing countriesK01AG037593 · NIA · STANFORD UNIVERSITY · PI GOLDHABER-FIEBERT, JEREMY DAVID · 2011 to 2015
$637k
HSRD VA I01 HX000889NIA NIH HHS K01 AG037593United States Department of Veterans Affairs I01 HX000889-1A1
6 · The paper itself

Abstract

backgroundThe release of highly effective but costly medications for the treatment of hepatitis C virus combined with a doubling in the incidence of hepatitis C virus have posed substantial financial challenges for many healthcare systems. We provide estimates of the cost of treating patients with hepatitis C virus that can inform the triage of pharmaceutical care in systems with limited healthcare resources.

methodsWe conducted an observational study using a national US cohort of 206,090 veterans with laboratory-identified hepatitis C virus followed from Fiscal Year 2010 to 2014. We estimated the cost of: non-advanced Fibrosis-4; advanced Fibrosis-4; hepatocellular carcinoma; liver transplant; and post-liver transplant. The former two stages were ascertained using laboratory result data; the latter stages were ascertained using administrative data. Costs were obtained from the Veterans Health Administration's activity-based cost accounting system and more closely represent the actual costs of providing care, an improvement on the charge data that generally characterizes the hepatitis C virus cost literature. Generalized estimating equations were used to estimate and predict costs per liver disease stage. Missing data were multiply imputed.

resultsAnnual costs of care increased as patients progressed from non-advanced Fibrosis-4 to advanced Fibrosis-4, hepatocellular carcinoma, and liver transplant (all p < 0.001). Post-liver transplant, costs decreased significantly (p < 0.001). In simulations, patients were estimated to incur the following annual costs: US $17,556 for non-advanced Fibrosis-4; US $20,791 for advanced Fibrosis-4; US $46,089 for liver cancer; US $261,959 in the year of the liver transplant; and US $18,643 per year after the liver transplant.

conclusionsCost differences of treating non-advanced and advanced Fibrosis-4 are relatively small. The greatest cost savings would be realized from avoiding progression to liver cancer and transplant.

Indexed as

Veterans HealthAgedAntiviral AgentsCost-Benefit AnalysisFemaleHepacivirusHepatitis C, ChronicHumansLiver CirrhosisMaleMiddle AgedUnited StatesAntiviral Agents

Identifiers

PMID31030359
PMCPMC12919761
OpenAlexW2941087251

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.