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Real World Cost-of-Illness Evidence in Hepatitis C Virus: A systematic review


  • T. Joseph Mattingly

    (University of Maryland School of Pharmacy)

  • Bryan L. Love

    (University of South Carolina College of Pharmacy)

  • Bilal Khokhar

    (General Dynamics Information Technology)


Background The introduction of direct-acting antivirals (DAAs) represents a potential clinical cure for hepatitis C virus (HCV) infection. Identification of costs associated with different stages of untreated disease through cost-of-illness (COI) evaluation helps inform policy decisions and cost-effectiveness analyses (CEAs). This study’s objective was to review published real-world costs for patients with HCV to estimate the COI across different stages of disease progression. Methods A literature search of EMBASE, Scopus, and PubMed from January 1, 2010 to August 31, 2019 was conducted to identify real-world evidence related to HCV. Data extraction included citation details, population, study type, costing method used, currency and inflation adjustments, and disease-specific costs. Standardized costing method categories (sum all medical, sum diagnosis specific, matching, regression, other incremental, and other total) were assigned. The risk of bias was assessed at the outcome level for influence on costs attributable to HCV. Results The search strategy identified 278 studies, with 31 included in the final review after inclusion and exclusion criteria were applied. Retrospective cohorts (77%) and cross-sectional analyses (16%) were most frequently encountered. Sum Diagnosis Specific was the most common costing method (39%), followed by Regression (32%). Of the 31 studies analyzed, 35% included costs that would be included in a societal model. Costs were identified for various stages and complications related to HCV disease progression. Several studies included were determined to have a high (48%) or moderate risk (42%) of bias related to COI estimates. Conclusion Cost estimates for formal, informal, and non-health care services were identified in this review, but several challenges still exist in fully quantifying HCV burden. Future modeling studies including cost inputs should critically evaluate the risk of bias based on costing methods and data sources.

Suggested Citation

  • T. Joseph Mattingly & Bryan L. Love & Bilal Khokhar, 2020. "Real World Cost-of-Illness Evidence in Hepatitis C Virus: A systematic review," PharmacoEconomics, Springer, vol. 38(9), pages 927-939, September.
  • Handle: RePEc:spr:pharme:v:38:y:2020:i:9:d:10.1007_s40273-020-00933-3
    DOI: 10.1007/s40273-020-00933-3

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    References listed on IDEAS

    1. T. Joseph Mattingly & Joseph F. Levy & Julia F. Slejko & Nneka C. Onwudiwe & Eleanor M. Perfetto, 2018. "Estimating Drug Costs: How do Manufacturer Net Prices Compare with Other Common US Price References?," PharmacoEconomics, Springer, vol. 36(9), pages 1093-1099, September.
    2. T. Joseph Mattingly & Julia F. Slejko & Eberechukwu Onukwugha & Eleanor M. Perfetto & Shyamasundaran Kottilil & C. Daniel Mullins, 2020. "Value in Hepatitis C Virus Treatment: A Patient-Centered Cost-Effectiveness Analysis," PharmacoEconomics, Springer, vol. 38(2), pages 233-242, February.
    3. T. Joseph Mattingly & C. Daniel Mullins & Eberechukwu Onukwugha, 2016. "Publication of Cost-of-Illness Studies: Does Methodological Complexity Matter?," PharmacoEconomics, Springer, vol. 34(10), pages 1067-1070, October.
    4. T. Joseph Mattingly & Julia F. Slejko & Eleanor M. Perfetto & Shyamasundaran Kottilil & C. Daniel Mullins, 2019. "What Matters Most for Treatment Decisions in Hepatitis C: Effectiveness, Costs, and Altruism," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 12(6), pages 631-638, December.
    5. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
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    Blog mentions

    As found by, the blog aggregator for Economics research:
    1. Rita Faria’s journal round-up for 14th September 2020
      by Rita Faria in The Academic Health Economists' Blog on 2020-09-14 11:00:07

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