Hepatitis C virus cure with direct acting antivirals: Clinical,economic, societal and patient value for China  

作　　者：Qing Xie Jian-Wei Xuan Hong Tang Xiao-Guang Ye Peng Xu I-Heng Lee Shan-Lian Hu 

机构地区：[1]Department of Infectious Diseases,Ruijin Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200025,China [2]Health Economic Research Institute,School of Pharmacy,Sun Yat-Sen University,Guangzhou 510006,Guangdong Province,China [3]Center of Infectious Diseases,West China Hospital of Sichuan University,Chengdu 610041,Sichuan Province,China [4]Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 510260,Guangdong Province,China [5]Gilead Sciences Inc,Shanghai 200122,China [6]Gilead Sciences Inc,Foster City,CA 94404,United States [7]School of Public Health,Fudan University,Shanghai 200032,China [8]Shanghai Health Development Research Center,Shanghai 200032,China

出　　处：《World Journal of Hepatology》2019年第5期421-441,共21页世界肝病学杂志（英文版）（电子版）

基　　金：funded by Gilead Sciences, Shanghai, China

摘　　要：About 10 million people in China are infected with hepatitis C virus(HCV),with the seroprevalence of anti-HCV in the general population estimated at 0.6%.Delaying effective treatment of chronic hepatitis C(CHC)is associated with liver disease progression,cirrhosis,hepatocellular carcinoma,and liver-related mortality.The extrahepatic manifestations of CHC further add to the disease burden of patients.Managing CHC-related advanced liver diseases and systemic manifestations are costly for both the healthcare system and society.Loss of work productivity due to reduced well-being and quality of life in CHC patients further compounds the economic burden of the disease.Traditionally,pegylatedinterferon plus ribavirin(PR)was the standard of care.However,a substantial number of patients are ineligible for PR treatment,and only 40%–75%achieved sustained virologic response.Furthermore,PR is associated with impairment of patient-reported outcomes(PROs),high rates of adverse events,and poor adherence.With the advent of direct acting antivirals(DAAs),the treatment of CHC patients has been revolutionized.DAAs have broader eligible patient populations,higher efficacy,better PRO profiles,fewer adverse events,and better adherence rates,thereby making it possible to cure a large proportion of all CHC patients.This article aims to provide a comprehensive evaluation on the value of effective,curative hepatitis C treatment from the clinical,economic,societal,and patient experience perspectives,with a focus on recent data from China,supplemented with other Asian and international experiences where China data are not available.About 10 million people in China are infected with hepatitis C virus(HCV), with the seroprevalence of anti-HCV in the general population estimated at 0.6%.Delaying effective treatment of chronic hepatitis C(CHC) is associated with liver disease progression, cirrhosis, hepatocellular carcinoma, and liver-related mortality. The extrahepatic manifestations of CHC further add to the disease burden of patients. Managing CHC-related advanced liver diseases and systemic manifestations are costly for both the healthcare system and society. Loss of work productivity due to reduced well-being and quality of life in CHC patients further compounds the economic burden of the disease. Traditionally, pegylatedinterferon plus ribavirin(PR) was the standard of care. However, a substantial number of patients are ineligible for PR treatment, and only 40%–75% achieved sustained virologic response. Furthermore, PR is associated with impairment of patient-reported outcomes(PROs), high rates of adverse events, and poor adherence. With the advent of direct acting antivirals(DAAs), the treatment of CHC patients has been revolutionized. DAAs have broader eligible patient populations, higher efficacy, better PRO profiles, fewer adverse events, and better adherence rates, thereby making it possible to cure a large proportion of all CHC patients. This article aims to provide a comprehensive evaluation on the value of effective, curative hepatitis C treatment from the clinical, economic, societal, and patient experience perspectives, with a focus on recent data from China,supplemented with other Asian and international experiences where China data are not available.

关 键 词：Hepatitis C VALUE of CURE Sustained VIROLOGIC response End stage liver disease Prevention of transmission COST-EFFECTIVENESS Productivity Societal VALUE Patient-reported outcomes 

分 类 号：R[医药卫生]