Table 1.
Hepatitis C Cohort Characteristics, Natural History, Costs, and Utilities
| Description | Base Case | Low | High | Distribution | Source |
|---|---|---|---|---|---|
| Cohort Characteristics | |||||
| Age (years) | 60 | 50 | 70 | Gamma | VA CCR |
| F0–2 (%) | 0.76 | 0.56 | 0.85 | Dirichlet | (34, 40) |
| F3 (%) | 0.12 | 0.11 | 0.44 | Dirichlet | (34, 40) |
| Interferon-Ineligible (%) | 0.37 | 0.20 | 0.57 | Beta | (41) |
| Genotype 1a (%) | 0.65 | 0.50 | 0.75 | Beta | (42, 43) |
| <6 million HCV RNA | 0.59 | 0 | 0.99 | Beta | (19) |
| Risk of Disease Progression (%) | |||||
| F0–2 to F3 | 0.12 | 0.11 | 0.13 | Beta | (44) |
| F3 to F4 | 0.12 | 0.09 | 0.14 | Beta | (44) |
| F3 to HCC | 0.01 | 0 | 0.03 | Beta | (45) |
| F4 to DC | 0.04 | 0.01 | 0.04 | Beta | (45, 46) |
| F4 to HCC | 0.03 | 0.01 | 0.08 | Beta | (45, 47) |
| DC to HCC | 0.07 | 0.03 | 0.08 | Beta | (48) |
| DC to Transplant | 0.03 | 0.02 | 0.06 | Beta | (40, 49) |
| HCC to Transplant | 0.04 | 0 | 0.14 | Beta | (50, 51) |
| Progression After SVR (%) | |||||
| F3 to HCC | 0.007 | 0.006 | 0.008 | Beta | (5) |
| F4 to DC | 0.005 | 0.002 | 0.096 | Beta | (25) |
| F4 to HCC | 0.005 | 0 | 0.019 | Beta | (13, 33, 53) |
| Mortality Rates | |||||
| Hepatitis C (RR)* | 2.37 | 1.28 | 4.38 | Lognormal | (52) |
| Cirrhosis (RR)† | 2.50 | 1.23 | 5.08 | Lognormal | (6) |
| SVR after F0–3 (RR)* | 1.00 | ||||
| SVR after F4 (RR)‡ | 0.39 | 0.14 | 0.65 | Lognormal | (5–7) |
| DC (%) | 0.10 | 0.04 | 0.21 | Beta | (48) |
| HCC (%) | 0.43 | 0.34 | 0.51 | Beta | (46) |
| Transplant Year 1 (%) | 0.14 | 0.06 | 0.42 | Beta | (53, 54) |
| Transplant Year 2+ (%) | 0.03 | 0.02 | 0.11 | Beta | (54) |
| Annual Follow-Up Costs (2014 $US) | |||||
| F0–3 | $190 | $90 | $555 | Gamma | (25) |
| F4 | $1,264 | $740 | $1,789 | Gamma | (25) |
| DC | $16,214 | $12,971 | $40,076 | Gamma | (25) |
| HCC Treatment | $50,754 | $26,124 | $75,384 | Gamma | (25) |
| Transplant Year 1 | $310,023 | $248,019 | $372,028 | Gamma | (25) |
| Transplant Year 2+ | $46,985 | $37,588 | $56,382 | Gamma | (25) |
| SVR (F0–2) | $0 | ||||
| Utilities before SVR | |||||
| F0–2 | 0.85 | 0.83 | 0.87 | Beta | (53, 55) |
| F3 | 0.79 | 0.77 | 0.81 | Beta | (53, 55) |
| F4 | 0.76 | 0.67 | 0.79 | Beta | (53, 55) |
| DC | 0.69 | 0.44 | 0.69 | Beta | (25) |
| HCC | 0.67 | 0.6 | 0.72 | Beta | (25) |
| Transplant Year 1 | 0.5 | 0.3 | 0.8 | Beta | (25) |
| Transplant Year 2+ | 0.77 | 0.57 | 0.77 | Beta | (25) |
| Utilities After SVR | |||||
| F0–2 | 0.92 | 0.9 | 0.94 | Beta | (25) |
| F3 | 0.86 | 0.84 | 0.88 | Beta | (25) |
| F4 | 0.83 | 0.81 | 0.85 | Beta | (25) |
Note: DC - decompensated cirrhosis, F0–2, F3, F4 - METAVIR stages of hepatic fibrosis, G1a - genotype 1a, HCC - hepatocellular carcinoma, RR - relative risk, SVR - sustained virologic response, VA CCR – VA Clinical Case Registry 2013
*
- compared to all-cause mortality,
†
- compared to F0–2,
‡
- compared to pre-treatment state.