Chronic hepatitis C: Burden of disease and cost associated with hospitalisations in France in 2012 (The HEPC-LONE study)

• Published in: Clinics and research in hepatology and gastroenterology 2016-06, Vol.40 (3), p.340-348
• Main Authors: Abergel, Armand, Rotily, Michel, Branchoux, Sébastien, Akremi, Raoudha, de Léotoing, Lucie, Vainchtock, Alexandre, Gaudin, Anne-Françoise
• Format: Article
• Language: English
• Subjects: Adult; Aged; Carcinoma, Hepatocellular - economics; Carcinoma, Hepatocellular - epidemiology; Female; France - epidemiology; Gastroenterology and Hepatology; Hepatitis C, Chronic - economics; Hepatitis C, Chronic - epidemiology; Hospital Mortality; Hospitalization - economics; Hospitalization - statistics & numerical data; Humans; Internal Medicine; Liver Cirrhosis - economics; Liver Cirrhosis - epidemiology; Liver Neoplasms - economics; Liver Neoplasms - epidemiology; Liver Transplantation - economics; Liver Transplantation - statistics & numerical data; Male; Middle Aged; Retrospective Studies; Severity of Illness Index
• ISSN: 2210-7401; 2210-741X
• DOI: 10.1016/j.clinre.2015.08.006

Summary Background and objective This retrospective hospital database analysis aimed to determine the burden and cost of hospitalisations related to chronic hepatitis C (CHC) infections in France in 2012. Methods All hospital stays with CHC (ICD-10 code B18.2) coded as the principal, related or significantly associated diagnosis were extracted from the French National Hospital database 2012 (PMSI). Hospitalisations not directly related to CHC were excluded. Patients were assigned to a liver disease stage, namely non-cirrhotic liver disease, compensated cirrhosis, decompensated cirrhosis, hepatocellular carcinoma or post-liver transplantation. Costing was performed using French national tariffs and expressed in 2013 Euros. We documented 22,056 hospital stays involving 12,040 patients who were considered to be directly related to CHC. Of these stays, 11,779 (53.4%) were documented in patients with severe complications (decompensated cirrhosis, hepatocellular carcinoma or liver transplantation). Results and conclusions The mean number and duration of hospital stays increased with disease severity. Overall, 1181 patients (9.8%) died during hospitalisation. The total cost of hospital stays for CHC was estimated to be € 61 million, of which 26.4% were attributable to hepatocellular carcinoma, 32.5% to post-liver transplantation and 21.0% to decompensated cirrhosis. Compared with a previous analysis in 2009, the number of patients hospitalised fell by 22%, although the patients hospitalised were overall more severely ill. The total cost of hospitalisation decreased by 8%, with a notably marked reduction in the number of biopsies performed (32%). This study illustrates the persistently high burden of CHC infections in France.