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Patient time costs and out-of-pocket costs in hepatitis C
Carole A Federico1, Priscilla C Hsu, Mel Krajden
1Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada.
Insights
Hepatitis C virus (HCV) infection incurs significant time and out-of-pocket costs for patients and caregivers. Successful treatment of HCV can reduce this economic burden, especially for low-income individuals.
Area of Science:
- Hepatology
- Health Economics
- Public Health
Background:
- Hepatitis C virus (HCV) infection imposes considerable financial and time burdens on patients, caregivers, and society.
- Understanding these costs is crucial for effective healthcare management and policy development.
Purpose of the Study:
- To evaluate the time and out-of-pocket (OOP) costs associated with Hepatitis C virus (HCV) infection for patients and their caregivers.
- To analyze how these costs vary across different disease stages and sociodemographic factors.
Main Methods:
- A patient-completed questionnaire was used to measure costs for 738 HCV outpatients at a tertiary-care clinic.
- Time and OOP costs were compared across disease stages and sociodemographic groups.
- Linear regression analysis, adjusting for covariates, examined the association between cost and disease stage.
Main Results:
- Mean annual time cost was $2136 (98 hours), ranging from $281 for those who cleared the virus to $9416 for transplant recipients.
- Mean annual OOP cost was $1326 per patient.
- Patients undergoing active treatment or with late-stage disease incurred $2500-$2800 annually, representing approximately 7% of their income. Low-income and unemployed individuals faced higher costs.
Conclusions:
- Out-of-pocket and time costs associated with Hepatitis C virus (HCV) infection represent a substantial economic burden, disproportionately affecting vulnerable populations.
- Successful antiviral therapy for HCV can significantly reduce both the health and economic burden for infected individuals.
Background:
Hepatitis C virus (HCV) infection is associated with substantial costs to patients, their caregivers and society.
Aims:
We evaluated time costs (time spent seeking healthcare) and out-of-pocket (OOP) costs for patients with HCV and their caregivers.
Methods:
We measured costs for 738 HCV outpatients in a tertiary-care clinic using a patient-completed questionnaire. Time and OOP costs were compared across disease stages and sociodemographic categories. We examined the association between cost and disease stage using linear regression adjusting for age, gender, marital status, education, income and Index of Coexistent Disease (ICED) comorbidity score. Costs were expressed in 2007 Canadian dollars.
Results:
The mean annual time cost per patient was $2136 (98 h), and ranged from $281 (18 h) in individuals who had cleared the virus to $9416 in transplant recipients (420 h). Caregiver costs were reported in 10% of patients. The mean annual OOP cost per patient was $1326. Patients receiving active treatment and those with late-stage disease spent $2500-2800 per year on HCV-related healthcare, approximately 7% of their annual income. Patients who had cleared the virus had the lowest time and OOP costs. Low income and unemployed patients had higher costs.
Conclusions:
In HCV-infected individuals, OOP and time costs represent a significant economic burden and fall disproportionately upon those least able to afford them. The lower cost burden among those who were successfully treated suggests that wider use of antiviral therapy may reduce economic burden in addition to improving health outcomes.
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