Center for Liver Diseases, Department of Medicine, Inova Fairfax Hospital, Falls Church, VA, United States.
Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, United States.
Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong.
University Medicine Cluster, National University Hospital, Singapore.
National Yang-Ming University, Taiwan.
Department of Gastroenterology, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, South Korea.
IMS Health, Singapore.
Chronic, untreated hepatitis C virus (HCV) infection is associated with a poor clinical prognosis and a detrimental impact on patients' lives, including on work productivity. To estimate the value of productivity losses due to genotype 1 (GT1) HCV infection in Hong Kong, Singapore, South Korea and Taiwan and to estimate the potential productivity gains associated with treating patients with ledipasvir/sofosbuvir (LDV/SOF) therapy,an economic model was developed with a time horizon of one year. HCV patients entered the model at 12 weeks post-treatment, having achieved or not achieved sustained virological response (SVR). Absenteeism and presenteeism rates were taken from a pooled analysis of data for US patients from the ION 1-3 studies. These rates were converted into hours of lost productivity, multiplied by the average wage and applied to the total employed, adult GT1 population in each country. Results were compared assuming no treatment and assuming all patients were treated with LDV/SOF. Total productivity losses due to untreated HCV were: $11.3 million, $17.1m, $146.0m and $349.1m in Hong Kong, Singapore, South Korea and Taiwan. LDV/SOF treatment resulted in economic gains of $4.5m, $6.8m, $58.7m and $138m, respectively. These gains were due to reduced presenteeism. The results were sensitive to changes in the prevalence of HCV and the average wage.In conclusion, productivity losses due to untreated HCV infection represent a substantial economic burden. By instituting universal HCV treatment with LDV/SOF (or other therapies with high SVR rates) productivity gains can be achieved.