The impact of LDV/SOF treatment on the work productivity of patients with chronic hepatitis C in Germany

S Mauss; N Smith; M Stepanova; Z Younossi

doi:10.1055/s-0035-1559174

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Z Gastroenterol 2015; 53 - KG148
DOI: 10.1055/s-0035-1559174

The impact of LDV/SOF treatment on the work productivity of patients with chronic hepatitis C in Germany

S Mauss ¹, N Smith ², M Stepanova ³, Z Younossi ⁴

¹Center for HIV and Hepatogastroenterology, Duesseldorf, Deutschland
²CB Partners, USA, Vereinigte Staaten
³Inova Fairfax Hospital, Falls Church, Virginia, USA, Vereinigte Staaten
⁴Inova Fairfax Medical Campus, Falls Church, Virginia, USA, Vereinigte Staaten

Congress Abstract

Background:

Chronic hepatitis C (CHC) is associated with increased presenteeism and absenteeism rates of patients. This creates a large economic burden for both employers and society. Ledipasvir/Sofosbuvir (LDV/SOF) is indicated for the treatment of CHC providing high efficacy, excellent tolerability and substantial quality of life improvement in clinical trials. An economic model was developed to assess the impact of LDV/SOF treatment vs. no treatment on work productivity for German CHC genotype 1 (GT1) patients.

Methods:

This cost-analysis model incorporates epidemiologic and economic data to estimate CHC GT1 patients' productivity gains with LDV/SOF treatment. We estimated the total number of CHC patients in the workforce using the employment rate among CHC patients (41.6%), GT1 prevalence (62.5%) and viraemic prevalence (0.3%) in the German population from published sources. Absenteeism and presenteeism rates were collected from ION 1 – 3 pivotal trials by the WPAI:Hepatitis C questionnaire (European participants). The cost of total work hours per patient (PP) was calculated using national working hours per year and labor costs. A sensitivity analysis was performed to assess the impact of a 20% reduction in labor costs and of employment rates, absenteeism and presenteeism by fibrosis stage.

Results:

Treatment of German CHC GT1 patients with LDV/SOF is expected to result in an annual societal productivity gain of 51.8 M€ (446.9 € PP) (Table I). Results from sensitivity analyses using reduced labour costs revealed savings of 41.4 M€ (357.6 € PP). Savings in productivity costs from LDV/SOF treatment are expected to be higher in cirrhotic (760.4 €) than in non-cirrhotic (544.8 €) patients; however, since non-cirrhotic patients represent 87.5% of the GT1 CHC population, the overall saving are higher for this subpopulation (Table I).

Conclusions: LDV/SOF treatment is estimated to improve the work productivity in CHC GT1 patients and significantly reduce costs related to productivity loss, both at patient and population level.

*Tab. KG 148*
Results	Base Case			Impact of wage – 20%			Non-cirrhotic population			Cirrhotic population
	Untreated	LDV/SOF treated	Annual productivity gain	Untreated	LDV/SOF treated	Annual productivity gain	Untreated	LDV/SOF treated	Annual productivity gain	Untreated	LDV/SOF treated	Annual productivity gain
n	115,851			115,851			101,369			14,481
Employment rate (HCV patients)	41.60% (published source)			41.60% (published source)			65.22% (from ION 1 – 3)			41.13% (from ION 1 – 3)
% achieving SVR	0%	91.8%	NA	0%	91.8%	NA	0%	94.1%	NA	0%	81.6%	NA
Total annual lost work productivity	308.9 M€	257.1 M€	51.8 M€	247.1 M€	205.7 M€	41.4 M€	380.0 M€	324.8 M€	55.2 M€	61.6 M€	50.6 M€	11.0 M€
Annual cost per patient due to lost work productivity	2,666.0 €	2,219.1 €	446.9 €	2,132.8 €	1,775.3 €	357.6 €	3,748.9 €	3,204.0 €	544.8 €	4,254.9 €	3,494.5 €	760.4 €