The Economic Value of Improved Productivity from Treatment of Chronic Hepatitis C Virus Infection: A Retrospective Analy
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BRIEF REPORT
The Economic Value of Improved Productivity from Treatment of Chronic Hepatitis C Virus Infection: A Retrospective Analysis of Earnings, Work Loss, and Health Insurance Data Mark Sulkowski . Raluca Ionescu-Ittu . Dendy Macaulay . Yuri Sanchez-Gonzalez
Received: June 29, 2020 / Accepted: September 2, 2020 / Published online: September 14, 2020 Ó The Author(s) 2020
ABSTRACT Introduction: Patients with chronic hepatitis C virus infection (HCV) may incur significant indirect costs due to health-related work loss. However, the impact of curative HCV therapy on work productivity is not well characterized. We estimated the economic value of improved productivity following HCV treatment. Methods: Adults diagnosed with HCV infection (Optum Healthcare Solutions data; Q1 1999 to Q1 2017) were stratified into two cohorts: (1) treated cohort, patients who received HCV therapy and (2) untreated cohort, therapy-naı¨ve patients. For the treated cohort, the index date Digital Features To view digital features for this article go to https://doi.org/10.6084/m9.figshare.12902408. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12325020-01492-x) contains supplementary material, which is available to authorized users. M. Sulkowski Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA R. Ionescu-Ittu (&) Analysis Group, Inc., Montre´al, QC, Canada e-mail: [email protected] D. Macaulay Analysis Group, Inc., New York, NY, USA Y. Sanchez-Gonzalez AbbVie, Inc., Mettawa, IL, USA
was set at the end of the post-treatment monitoring period, assumed to be 6 months after the end of treatment for patients with cirrhosis or for those treated with interferon-based therapy, and 3 months after the end of treatment for patients without cirrhosis who received interferon-free therapy. For the untreated cohort, an index date was randomly selected post-HCV diagnosis. Time from the index date to the first work-loss event was assessed using time to event analyses. An economic modeling approach was used to monetize the improved productivity from reduced risk of work-loss event in the 4 years post-index. Results: Patients in the treated cohort had a lower risk of experiencing a work-loss event compared to untreated patients [unadjusted and adjusted hazard ratios and 95% CI 0.72 (0.61–0.86), and 0.68 (0.55–0.85), respectively; p \ 0.001 for both]. The mean cumulative added productivity value associated with HCV treatment was US$4511 (CI $2778–$6278) at 1 year post-index and $21,429 (CI $12,733–$30,199) at 4 years post-index. Conclusion: HCV treatment reduces the risk of work loss resulting in productivity gains for employers and employees. The monetary value associated with these productivity gains is substantial, and, after about 4 years, it is comparable to the wholesale acquisition cost of some direct-acting antiviral regimens in the United States. Employers may derive economic benefits from adopting HCV elimination strategies.
Adv Ther (2020)
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