Experts say Canadian health care system not prepared for a 60 per cent increase in total health care costs in the next two decades
TORONTO, May 27, 2014 /CNW/ - The Canadian Liver Foundation (CLF) today announced the publication of a new analysis on the long-term impact of hepatitis C virus infection in Canada prepared by leading specialists that projects that Canada will experience a significant increase in cases of advanced hepatitis C-related liver disease over the next 20 years. Associated health care costs will also increase dramatically, mainly attributable to cirrhosis and its complications including liver cancer and liver transplantation.
According to Burden of Disease and Cost of Chronic Hepatitis C Virus Infection in Canada, published in the Canadian Journal of Gastroenterology and Hepatology (May 2014), by 2035, the population with chronic hepatitis C who have cirrhosis and more advanced hepatitis C-related disease will rise to 23 per cent from 8.7 per cent in 2013. Compared to 2013, Canada will experience an increase of 89 per cent in cases of compensated cirrhosis (scarring of the liver with no loss of function) and an increase of 80 per cent in cases of decompensated cirrhosis (severe scarring of the liver with advanced symptoms and loss of function). The analysis projects an increase of 205 per cent in cases of liver cancer and an increase of 160 per cent in cases of liver-related deaths. The authors report that these increases are "substantially greater" than those previously projected by the Public Health Agency of Canada that underestimate the true burden of hepatitis C in Canada.
While the new report reveals that the prevalence of hepatitis C infection peaked in 2003, the longer-term associated health care costs will increase by 60 per cent to $258.4 million at the peak in 2032 from $161.4 million in 2013 as patients age and their liver disease progresses (Note: cost projections do not include antiviral therapy, virology testing and indirect medical costs). The analysis determines that by 2032, 81 per cent of the total health care costs of hepatitis C will be attributable to more advanced liver disease, up from 56 per cent in 2013. In addition, the authors estimate that the lifetime cost for a hypothetical male 35 to 39 years of age with hepatitis C is $64,694, but varies substantially according to disease state - ranging from $51,946 for a patient with no fibrosis in 2013 up to $327,608 for a patient requiring liver transplantation in 2013.
"The Canadian health care system is not prepared to confront the impending epidemic of advanced hepatitis C-related liver disease and associated health care costs," said Dr. Robert Myers, Director of the Viral Hepatitis Clinic at the University of Calgary and lead author of the article. "There is an urgent need to initiate strategies to enhance the identification of new and existing cases of hepatitis C and to optimize the utilization of new antiviral therapies that treat multiple hepatitis C genotypes and have the highest cure rates with minimal side effects."
The article states that at current levels of diagnosis and treatment in Canada, patients will face a significant risk of death due to complications of hepatitis C in the coming years. In fact, the authors estimate that more than 32,000 hepatitis C-infected individuals will die of liver-related causes between 2013 and 2035, and that premature death will be substantial with patients only living to an average age of 68 years compared with an average life expectancy in Canada of 81 years.
"We are already seeing increases in liver cancer rates that are linked to hepatitis C infection, and without a concerted effort to identify and treat patients we will be facing dire consequences to both individuals and health care systems," said Dr. Morris Sherman, Chairman, Canadian Liver Foundation and a co-author of the article. "Today, we are seeing significantly more patients with compensated cirrhosis than decompensated cirrhosis, but the annual costs of dealing with decompensated cirrhosis are four times greater. So with decompensated cirrhosis estimated to increase by 80 per cent by 2035, this emphasizes the need for early diagnosis and treatment."
"With estimates that approximately 75 per cent of hepatitis C patients will have early-stage disease at any given point in time, this represents a window of opportunity to intervene before their health starts to rapidly deteriorate," said Dr. Mel Krajden, Medical Head, Hepatitis and Associate Medical Director, BCCDC Public Health Microbiology and Reference Laboratory, BC Centre for Disease Control, and a co-author of the article. "Given that short course, well tolerated treatments are already available and will soon be able to cure greater than 95 per cent of infections, we must find solutions to make treatment accessible for those who need it."
Another strategy outlined in the article, and recommended by the CLF, is to ensure Canadians born between 1945 and 1975 are screened for hepatitis C. The CLF has been urging the federal government to work with the provinces to develop strategies to eradicate hepatitis C.
"Hepatitis C is curable in most patients. We have an opportunity to act now to be proactive and treat more patients prior to them progressing to more advanced stages of disease when treatment becomes less effective and less well tolerated," said Dr. Myers. "With these new projections around the future burden and costs of hepatitis C, it is time to shift our thinking from the short-term pain associated with the costs of screening and antiviral therapy, to the long-term gain attributable to preventing hepatitis C-related complications."
About the Canadian Liver Foundation
Founded in 1969 by a group of doctors and business leaders concerned about the increasing incidence of liver disease, the Canadian Liver Foundation (CLF) was the first organization in the world devoted to providing support for research and education into the causes, diagnoses, prevention and treatment of all liver disease. Through its chapters across the country, the CLF strives to promote liver health, improve public awareness and understanding of liver disease, raise funds for research and provide support to individuals affected by liver disease.
Image with caption: "Burden of Hepatitis C: The Future Costs of Not Treating (CNW Group/Canadian Liver Foundation)". Image available at: http://photos.newswire.ca/images/download/20140527_C7017_PHOTO_EN_40776.jpg
Image with caption: "Burden of Hepatitis C: The Future Toll of Illness (CNW Group/Canadian Liver Foundation)". Image available at: http://photos.newswire.ca/images/download/20140527_C7017_PHOTO_EN_40777.jpg
SOURCE: Canadian Liver Foundation
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