OBJECTIVES: The objective of the review was to determine the most widely used estimates of United States (US) costs of different stages of liver disease in patients with hepatitis C virus (HCV) in cost-effectiveness analyses (CEA).
METHODS: A systematic literature search using predetermined search terms was performed to identify English-language articles that report cost or CEA from 1995 to 2014. Full texts were obtained and reviewed to determine study eligibility on the basis of predefined inclusion and exclusion criteria. All costs were inflated to 2014 values.
RESULTS: A total of 53 articles were eligible for review. In primary cost studies, two methods were generally used to derive the disease state costs: microcosting using treatment algorithms and unit costs; or statistical analyses of observational databases. The most widely used primary cost estimates in CEAs completed before 2011 were those derived using treatment algorithms by Bennett and colleagues (1997). A CEA published in 2012 by Gellad and colleagues presented updated resource use and costs for all the disease stages based on the Bennett study and added mild/moderate chronic HCV, compensated cirrhosis, and post-SVR health states. The most widely used primary cost estimates in CEAs completed after 2012 are those obtained from a large database study by McAdam-Marx and colleagues (2011). This study provides estimates for all liver stages but does not include subcategories for decompensated disease. The estimates from the different sources were quite different; for example, for cirrhosis and hepatocellular carcinoma Gellad estimated $745 and $45,728 per year while McAdam-Marx estimated $2,584 and $50,658 per year, respectively.
CONCLUSIONS: There are many estimates of costs of HCV liver disease and these estimates can vary widely due to differences in study methodology. Understanding the differences in these estimates can aid in the selection of the most appropriate inputs for use in economic models.
