Epidemiology, patient profile, and health care resource use for hepatitis C in Italy

Diego Sangiorgi,1 Valentina Perrone,1 Stefano Buda,1 Lucio Boglione,2 Giuseppe Cariti,2 Cinira Lefevre,3 Carmela Nappi,4 Luca Degli Esposti1 1Health, Economics and Outcomes Research, CliCon Srl, Ravenna, Italy; 2Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Turin, Turin, Italy; 3Center of Observational Research and Data Sciences, Bristol-Myers Squibb, Rueil-Malmaison, France; 4Health Economics, Bristol-Myers Squibb S.r.l., Rome, Italy Objective: The objectives of this study were to estimate the prevalence of Hepatitis C among six Italian Local Health Units (LHUs), to describe patient and antiviral drug characteristics, and to estimate the health care consumption rates and related costs for the management of patients affected by hepatitis C virus (HCV) infection by using data from routine clinical practice.Methods: We conducted a retrospective study using administrative databases of six Italian LHUs. All patients who had a record related to HCV during the enrollment period (July 1, 2009, to December 31, 2014) and who had at least 6 months of data available prior to the first HCV record were included. The date of the first record related to HCV during the enrollment period was considered as a proxy of diagnosis and used as the index date. Patients were followed from the index date up to 1 year, death, or exiting the database. Using the overall cohort of HCV adult patients as the numerator, we estimated the prevalence of HCV among six LHUs. The denominators were obtained from the National Institute of Statistics (N=1,665,682). We also evaluated descriptive patient’s characteristics and treatment patterns, and estimated health care consumption rates and related costs for the management of the HCV patients. Results: A total of 7,550 patients were analyzed, of whom 57% were male with a mean age of 57.6±16.4 years. The prevalence of HCV was estimated to be 0.45% (95% confidence interval 0.44–0.46). During the follow-up period, 78.6% of HCV patients had received no antiviral treatment. The annual health care cost associated with HCV infection was €6,022.7 (±7,922.6) while the cost specific to HCV care was €3,154.6 (±4,972.0)Conclusion: Our findings showed that, in the Italian real-world setting, only a small proportion of HCV-infected patients received an antiviral treatment. Despite the current low prevalence of HCV, the economic impact of such disease remains high. Keywords: hepatitis C virus infection, prevalence, antiviral drug, health care resources use, real-world data