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Cirrhosis | New Analysis Reveals The Escalating Costs Associated With Untreated Chronic Hepatitis C


The Canadian Liver Foundation (CLF) today announced the publication of a new analysis on the long-term impact of hepatitis C virus infection in Canada prepared by leading specialists that projects that Canada will experience a significant increase in cases of advanced hepatitis C-related liver disease over the next 20 years. Associated health care costs will also increase dramatically, mainly attributable to cirrhosis and its complications including liver cancer and liver transplantation.

According to Burden of Disease and Cost of Chronic Hepatitis C Virus Infection in Canada , published in the Canadian Journal of Gastroenterology and Hepatology (May 2014), by 2035, the population with chronic hepatitis C who have cirrhosis and more advanced hepatitis C-related disease will rise to 23 per cent from 8.7 per cent in 2013. Compared to 2013, Canada will experience an increase of 89 per cent in cases of compensated cirrhosis (scarring of the liver with no loss of function) and an increase of 80 per cent in cases of decompensated cirrhosis (severe scarring of the liver with advanced symptoms and loss of function). The analysis projects an increase of 205 per cent in cases of liver cancer and an increase of 160 per cent in cases of liver-related deaths. The authors report that these increases are “substantially greater” than those previously projected by the Public Health Agency of Canada that underestimate the true burden of hepatitis C in Canada.

While the new report reveals that the prevalence of hepatitis C infection peaked in 2003, the longer-term associated health care costs will increase by 60 per cent to $258.4 million at the peak in 2032 from $161.4 million in 2013 as patients age and their liver disease progresses (Note: cost projections do not include antiviral therapy, virology testing and indirect medical costs). The analysis determines that by 2032, 81 per cent of the total health care costs of hepatitis C will be attributable to more advanced liver disease, up from 56 per cent in 2013. In addition, the authors estimate that the lifetime cost for a hypothetical male 35 to 39 years of age with hepatitis C is $64,694, but varies substantially according to disease state ” ranging from $51,946 for a patient with no fibrosis in 2013 up to $327,608 for a patient requiring liver transplantation in 2013.

“The Canadian health care system is not prepared to confront the impending epidemic of advanced hepatitis C-related liver disease and associated health care costs,” said Dr. Robert Myers, Director of the Viral Hepatitis Clinic at the University of Calgary and lead author of the article. “There is an urgent need to initiate strategies to enhance the identification of new and existing cases of hepatitis C and to optimize the utilization of new antiviral therapies that treat multiple hepatitis C genotypes and have the highest cure rates with minimal side effects.”

The article states that at current levels of diagnosis and treatment in Canada, patients will face a significant risk of death due to complications of hepatitis C in the coming years. In fact, the authors estimate that more than 32,000 hepatitis C-infected individuals will die of liver-related causes between 2013 and 2035, and that premature death will be substantial with patients only

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