Skip to main content
Top
Published in: Infectious Diseases and Therapy 3/2018

Open Access 01-09-2018 | Original Research

Clinical and Economic Burden of Hepatic and Extrahepatic Complications from Chronic Hepatitis C: A Retrospective Analysis of German Sickness Fund Data

Authors: Michael R. Kraus, Henning Kleine, Stefanie Thönnes, Marc Pignot, Yuri Sanchez Gonzalez

Published in: Infectious Diseases and Therapy | Issue 3/2018

Login to get access

Abstract

Introduction

German data regarding the burden of complications from chronic hepatitis C (CHC) virus infection are limited. To address this issue, this study evaluates the clinical and economic burden of hepatic and extrahepatic complications (EHCs) associated with CHC in Germany.

Methods

This retrospective, cross-sectional study used claims data from the Betriebskrankenkasse German sickness fund (2007–2014) to assess the risks and medical costs of hepatic complications and EHCs, including conditions that are prevalent and behavioral factors associated with CHC. Prevalence, incidence, and risks were calculated for 1:1 matched patients with and without CHC (= 3994). All-cause cost, medical costs related to hepatic and EHCs, as well as CHC-related and non-CHC-related pharmacy costs (adjusted to the 2016 Euro rate), were calculated and compared between 1:5 matched patients with (n = 8425) and without CHC (n = 42,125).

Results

Patients with CHC had a 3-fold higher risk for any EHC (OR = 3.0; P < 0.05) and higher EHC-related medical costs (adjusted difference, €1606; P < 0.01) compared with patients without CHC. Total costs (€10,108 vs. €5430), hepatic complication-related medical costs (€1425 vs. €556), EHC-related costs (€3547 vs. €1921), CHC-related pharmacy costs (€577 vs. €116), and non-CHC-related pharmacy costs (€3719 vs. €1479) were all significantly greater for patients with CHC compared with patients without CHC. EHC-related medical costs were a major contributor to the higher all-cause medical (84.4%) and total (44.3%) cost differences between patients with CHC and the matched sample of patients without CHC.

Conclusion

CHC is associated with substantial clinical and economic burden in Germany, largely due to hepatic complications and EHCs.

Funding

Abbvie Inc.
Footnotes
1
G (abbreviation for "gesicherte Diagnose") = assured diagnosis; Z ("Zustand nach") = condition after.
 
Literature
1.
go back to reference Younossi Z, Park H, Henry L, et al. Extrahepatic manifestations of hepatitis C: a meta-analysis of prevalence, quality of life, and economic burden. Gastroenterology. 2016;150:1599–608.CrossRefPubMed Younossi Z, Park H, Henry L, et al. Extrahepatic manifestations of hepatitis C: a meta-analysis of prevalence, quality of life, and economic burden. Gastroenterology. 2016;150:1599–608.CrossRefPubMed
2.
go back to reference Gower E, Estes C, Blach S, et al. Global epidemiology and genotype distribution of the hepatitis C virus infection. J Hepatol. 2014;61:S45–57.CrossRefPubMed Gower E, Estes C, Blach S, et al. Global epidemiology and genotype distribution of the hepatitis C virus infection. J Hepatol. 2014;61:S45–57.CrossRefPubMed
5.
go back to reference Poethko-Muller C, Zimmermann R, Hamouda O. et al [Epidemiology of hepatitis A, B, and C among adults in Germany: results of the German Health Interview and Examination Survey for Adults (DEGS1)]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2013;56:707–15.CrossRefPubMed Poethko-Muller C, Zimmermann R, Hamouda O. et al [Epidemiology of hepatitis A, B, and C among adults in Germany: results of the German Health Interview and Examination Survey for Adults (DEGS1)]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2013;56:707–15.CrossRefPubMed
6.
go back to reference Razavi H, Waked I, Sarrazin C, Myers RP, Idilman R, Calinas F, et al. The present and future disease burden of hepatitis C virus (HCV) infection with today’s treatment paradigm. J Viral Hepatitis. 2014;21(Suppl 1):34–59.CrossRef Razavi H, Waked I, Sarrazin C, Myers RP, Idilman R, Calinas F, et al. The present and future disease burden of hepatitis C virus (HCV) infection with today’s treatment paradigm. J Viral Hepatitis. 2014;21(Suppl 1):34–59.CrossRef
7.
go back to reference Guidelines for the screening, care and treatment of persons with chronic hepatitis C infection. World Health Organization; 2016 April. (ISBN 978 92 4 154961 5). Guidelines for the screening, care and treatment of persons with chronic hepatitis C infection. World Health Organization; 2016 April. (ISBN 978 92 4 154961 5).
8.
go back to reference Younossi ZM, Tanaka A, Eguchi Y, et al. The impact of hepatitis C virus outside the liver: evidence from Asia. Liver Int. 2017;37:159–72.CrossRefPubMed Younossi ZM, Tanaka A, Eguchi Y, et al. The impact of hepatitis C virus outside the liver: evidence from Asia. Liver Int. 2017;37:159–72.CrossRefPubMed
9.
go back to reference Nevens F, Colle I, Michielsen P, et al. Resource use and cost of hepatitis C-related care. Eur J Gastroenterol Hepatol. 2012;24:1191–8.CrossRefPubMed Nevens F, Colle I, Michielsen P, et al. Resource use and cost of hepatitis C-related care. Eur J Gastroenterol Hepatol. 2012;24:1191–8.CrossRefPubMed
11.
go back to reference Cacoub P, Comarmond C, Domont F, et al. Extrahepatic manifestations of chronic hepatitis C virus infection. Ther Adv Infect Dis. 2016;3:3–14.PubMedPubMedCentral Cacoub P, Comarmond C, Domont F, et al. Extrahepatic manifestations of chronic hepatitis C virus infection. Ther Adv Infect Dis. 2016;3:3–14.PubMedPubMedCentral
12.
go back to reference Wijarnpreecha K, Chesdachai S, Jaruvongvanich V, Ungprasert P. Hepatitis C virus infection and risk of Parkinson’s disease: a systematic review and meta-analysis. Eur J Gastroenterol Hepatol. 2018;30:9–13.CrossRefPubMed Wijarnpreecha K, Chesdachai S, Jaruvongvanich V, Ungprasert P. Hepatitis C virus infection and risk of Parkinson’s disease: a systematic review and meta-analysis. Eur J Gastroenterol Hepatol. 2018;30:9–13.CrossRefPubMed
13.
go back to reference Khalsa JH, Treisman G, McCance-Katz E, Tedaldi E. Medical consequences of drug abuse and co-occurring infections: research at the National Institute on Drug Abuse. Subst Abus. 2008;29:5–16.CrossRefPubMedPubMedCentral Khalsa JH, Treisman G, McCance-Katz E, Tedaldi E. Medical consequences of drug abuse and co-occurring infections: research at the National Institute on Drug Abuse. Subst Abus. 2008;29:5–16.CrossRefPubMedPubMedCentral
15.
go back to reference Balakrishnan M, Glover MT, Kanwal F. Hepatitis C and risk of nonhepatic malignancies. Clin Liver Dis. 2017;21:543–54.CrossRefPubMed Balakrishnan M, Glover MT, Kanwal F. Hepatitis C and risk of nonhepatic malignancies. Clin Liver Dis. 2017;21:543–54.CrossRefPubMed
16.
go back to reference Dibonaventura MD, Yuan Y, Lescrauwaet B, et al. Multicountry burden of chronic hepatitis C viral infection among those aware of their diagnosis: a patient survey. PLoS ONE. 2014;9:SP227-35.CrossRef Dibonaventura MD, Yuan Y, Lescrauwaet B, et al. Multicountry burden of chronic hepatitis C viral infection among those aware of their diagnosis: a patient survey. PLoS ONE. 2014;9:SP227-35.CrossRef
17.
go back to reference Vietri J, Prajapati G, El Khoury AC. The burden of hepatitis C in Europe from the patients’ perspective: a survey in 5 countries. BMC Gastroenterol. 2013;13:16.CrossRefPubMedPubMedCentral Vietri J, Prajapati G, El Khoury AC. The burden of hepatitis C in Europe from the patients’ perspective: a survey in 5 countries. BMC Gastroenterol. 2013;13:16.CrossRefPubMedPubMedCentral
18.
go back to reference Stahmeyer JT, Rossol S, Bert F, et al. Cost of treating hepatitis C in Germany: a retrospective multicenter analysis. Eur J Gastroenterol Hepatol. 2014;26:1278–85.CrossRefPubMed Stahmeyer JT, Rossol S, Bert F, et al. Cost of treating hepatitis C in Germany: a retrospective multicenter analysis. Eur J Gastroenterol Hepatol. 2014;26:1278–85.CrossRefPubMed
19.
go back to reference Solinis RN, Ugarte PA, Rojo A, et al. Value of treating all stages of chronic hepatitis C: a comprehensive review of clinical and economic evidence. Infect Dis Ther. 2016;5:491–508.CrossRef Solinis RN, Ugarte PA, Rojo A, et al. Value of treating all stages of chronic hepatitis C: a comprehensive review of clinical and economic evidence. Infect Dis Ther. 2016;5:491–508.CrossRef
20.
go back to reference Reau N, Vekeman F, Wu E, et al. Prevalence and economic burden of extrahepatic manifestations of hepatitis C virus are underestimated but can be improved with therapy. Hepatol Commun. 2017;1:439–52.CrossRefPubMedPubMedCentral Reau N, Vekeman F, Wu E, et al. Prevalence and economic burden of extrahepatic manifestations of hepatitis C virus are underestimated but can be improved with therapy. Hepatol Commun. 2017;1:439–52.CrossRefPubMedPubMedCentral
21.
go back to reference Tengan FM, Levy-Neto M, Miziara ID, Dantas BP, Maragno L. Extrahepatic manifestations of chronic hepatitis C infection: a consecutive study in Brazilian patients. Braz J Infect Dis. 2017;21:203–4.CrossRefPubMed Tengan FM, Levy-Neto M, Miziara ID, Dantas BP, Maragno L. Extrahepatic manifestations of chronic hepatitis C infection: a consecutive study in Brazilian patients. Braz J Infect Dis. 2017;21:203–4.CrossRefPubMed
22.
go back to reference Cacoub P, Buggisch P, Beckerman R, et al. Direct medical costs associated with the extrahepatic manifestations of hepatitis C infection. J Hepatol. 2017;66:S499.CrossRef Cacoub P, Buggisch P, Beckerman R, et al. Direct medical costs associated with the extrahepatic manifestations of hepatitis C infection. J Hepatol. 2017;66:S499.CrossRef
23.
go back to reference Mohammed RH, ElMakhzangy HI, Gamal A, et al. Prevalence of rheumatologic manifestations of chronic hepatitis C virus infection among Egyptians. Clin Rheumatol. 2010;29:1373–80.CrossRefPubMed Mohammed RH, ElMakhzangy HI, Gamal A, et al. Prevalence of rheumatologic manifestations of chronic hepatitis C virus infection among Egyptians. Clin Rheumatol. 2010;29:1373–80.CrossRefPubMed
24.
go back to reference Cheng Z, Zhou B, Shi X, et al. Extrahepatic manifestations of chronic hepatitis C virus infection: 297 cases from a tertiary medical center in Beijing, China. Chin Med J (Engl). 2014;127:1206–10.PubMed Cheng Z, Zhou B, Shi X, et al. Extrahepatic manifestations of chronic hepatitis C virus infection: 297 cases from a tertiary medical center in Beijing, China. Chin Med J (Engl). 2014;127:1206–10.PubMed
Metadata
Title
Clinical and Economic Burden of Hepatic and Extrahepatic Complications from Chronic Hepatitis C: A Retrospective Analysis of German Sickness Fund Data
Authors
Michael R. Kraus
Henning Kleine
Stefanie Thönnes
Marc Pignot
Yuri Sanchez Gonzalez
Publication date
01-09-2018
Publisher
Springer Healthcare
Published in
Infectious Diseases and Therapy / Issue 3/2018
Print ISSN: 2193-8229
Electronic ISSN: 2193-6382
DOI
https://doi.org/10.1007/s40121-018-0204-3

Other articles of this Issue 3/2018

Infectious Diseases and Therapy 3/2018 Go to the issue