PS2-20 HEALTH UTILITIES IN CHRONIC HEPATITIS C PATIENTS WITH LATE-STAGE LIVER DISEASE

Monday, October 24, 2016
Bayshore Ballroom ABC, Lobby Level (Westin Bayshore Vancouver)
Poster Board # PS2-20

Yasmin Saeed, BScPhm1, Alice Fried2, Mohammed Alhokail1, Suzanne Chung, BEd, CCRP3, Welson Ryan1, Josephine F Wong, MD1, Jordan J. Feld, MD, MPH4, David Wong, MD, FRCP4, Hemant Shah, MD, MScCH4, Julie Bruneau, MD5, Zeny Feng, PhD6, Nicholas Mitsakakis, MSc PhD1, Jeff Powis, MD7, Valeria E. Rac, MD, PhD1, Karen E Bremner, BSc8, Murray Krahn, MD, MSc, FRCPC1 and William W. L. Wong, PhD9, (1)Toronto Health Economics and Technology Assessment (THETA) Collaborative, Toronto, ON, Canada, (2)University of Toronto and University Health Network, Toronto General Research Institute, Toronto Health Economics and Technology Assessment (THETA) Collaborative, Toronto, ON, Canada, (3)Toronto Health Economics and Technology Assessment (THETA) Collaborative, University of Toronto, Toronto, ON, Canada, (4)Toronto Centre for Liver Disease, University Health Network, Toronto, ON, Canada, (5)Department of Family Medicine, Université de Montréal, Montreal, QC, Canada, (6)Department of Mathematics and Statistics, University of Guelph, Guelph, ON, Canada, (7)Toronto Community Hepatitis C Program (TCHCP), Toronto, ON, Canada, (8)Toronto General Research Institute, Toronto General Hospital, Toronto, ON, Canada, (9)School of Pharmacy, University of Waterloo, Kitchener, ON, Canada
Purpose:

   Previously published health utilities from late-stage chronic hepatitis C (CHC) patients have been drawn from a small sample of patients, and have been higher than expected in relation to the severity of disease. This has led to skepticism regarding the validity of these results.

    Our study aims to measure health utilities in CHC patients with advanced liver disease in order to better understand the burden of CHC as well as the benefits of screening and treatment programs aimed at preventing or minimizing advanced liver disease.

Method:

   In this ongoing pilot study, we are measuring the health utilities of 100 CHC patients attending the liver clinic and liver transplant clinic at Toronto General Hospital, Toronto, Ontario. Patients with compensated cirrhosis, decompensated cirrhosis, and/or hepatocellular carcinoma are being recruited.

    Patients are being asked to complete the EQ-5D, HUI 2/3, VAS, TTO, and SF-6D utility instruments as well as provide demographic and clinical information.

   We are estimating utilities separately for different subpopulations based on severity of liver disease. A regression model is being formulated to assess the effects of socio-demographic and clinical variables on utilities.

Result:

   Preliminary data have been analyzed from 50 patients to date. Most patients were male (65%) with an average age of 60. Sixty-four percent had compensated cirrhosis; 19% had current or past decompensated cirrhosis; and 17% had current or past hepatocellular carcinoma.

   Many patients reported a history of substance dependence (48% intravenous drug use, 18% alcohol) but none reported current intravenous or intranasal drug use. Additionally, 53% of patients reported a history of mental illness.

   The mean (SE) utilities were: EQ-5D 0.764 (0.034); HUI2 0.774 (0.036); HUI3 0.677 (0.055); VAS 0.721 (0.031); TTO 0.801 (0.033); and SF-6D 0.700 (0.024).

   Conclusion:

  Our results provide much-needed data on the impact of late-stage CHC on health utilities and will help to reduce the uncertainty surrounding previous estimates. With many promising but costly new treatments recently becoming available for CHC, it will be important to evaluate their cost-effectiveness with consideration of the impacts of late-stage disease and the benefits of averting these impacts. Our findings will increase the accuracy of future economic evaluations of hepatitis C screening and treatment and shed light on the burden of late-stage CHC.

See more of: POSTER SESSION II: LEE B. LUSTED FINALISTS' MODERATED POSTER SESSION & CONTINENTAL BREAKFAST

See more of: 38th Annual North American Meeting of the Society for Medical Decision Making