Chronic hepatitis C is expensive for Ontario patients and caregivers

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Ontarians with chronic hepatitis C can lose up to 20 per cent of their overall income managing their condition, a new study has found.

Using survey results from 275 patients, the study analyzed the financial burden of chronic hepatitis C (CHC) on patients treated in hospital and community clinics.

The research team determined that patients treated in hospital hepatitis clinics spent up to five times more out-of-pocket on supporting their CHC needs than those treated in community hepatitis clinics.

“Understanding the true economic cost of chronic hepatitis C helps inform policy decision-making,” said William W.L. Wong, professor at the School of Pharmacy and lead author on the study. “Though previous research existed to show the direct medical costs of managing CHC patients in the health-care system, Ontario research was lacking on the cost to individual patients and caregivers.”

Wong and his coauthors addressed this gap by examining both the out-of-pocket costs to patients and the productivity-related costs of missing work for patients and caregivers due to CHC. The team found that the hospital-treated patients group lost an average of $743 in time over a three-month period and the community clinic-treated patients group lost an average of $465. Combined, the out-of-pocket expenses and time-costs represent an average of 10.6 per cent of a hospital patient’s income and 20.7 per cent of a community clinic patient’s income.

Fifty-five to 85 per cent of people who contract hepatitis C progress to chronic infection, which poses risk for serious complications that increase the risk of premature death.  More than 70 million people worldwide are living with CHC.

“By quantifying just how much patients and their caregivers spend managing CHC and being aware of the income they lose out from being unable to work, we can identify gaps in social benefits and make specific recommendations to support patients in each setting,” Wong said. “For example, in our hospital group, we saw 42 per cent of the patients reported having caregivers, whereas in the community clinic, only five per cent of the patients reported, reflecting lack of social support for this group.”

The study, “Time Costs and Out-of-Pocket Costs in Chronic Hepatitis C Patients in a Publicly Funded Health System,” is currently in press and will be published February 2022 in the journal Value in Health.