Direct medical costs associated with the extrahepatic manifestations of hepatitis C virus infection in France

BackgroundThe economic impact of extrahepatic manifestations of hepatitis C virus (HCV) infection remains unknown for France. AimTo estimate the prevalence of extrahepatic manifestations of HCV and the direct medical costs associated with them. MethodsEstimates of 13 extrahepatic manifestations prevalence were obtained from (1) a retrospective data analysis of HCV-infected patients in a specialised centre and the baseline prevalence in the general French population and (2) an international systematic review. Per-patient-per-year costs to treat these manifestations were obtained from the literature, national databases or expert opinion. The impact of achieving HCV cure after anti-viral therapy was applied to the French healthcare costs. ResultsUsing approach (1), increased prevalence rates in HCV patients compared to the general population were observed for most extrahepatic manifestations. The mean per-patient-per-year cost of these manifestations in the tertiary centre was 3296 Euro [95% CI 1829; 5540]. In France, HCV-extrahepatic manifestations amounted to a total cost of 215 million (M) Euro per year [144; 299]. Using approach (2), the mean per-patient-per-year cost was estimated to be 1117 Euro. The estimated total cost reduction in France associated with HCV cure was 13.9MEuro for diabetes, 8.6MEuro for cryoglobulinemia vasculitis, 6.7MEuro for myocardial infarction, 2.4MEuro for end-stage renal disease and 1.4MEuro for stroke. ConclusionExtrahepatic manifestations of HCV infection substantially add to the overall economic burden of the disease in France. HCV cure after anti-viral therapy is expected to significantly reduce the total costs of managing these manifestations in France.