Health Utilities in People with Chronic Hepatitis C

Background: Hepatitis C virus infection is associated with reduced quality of life. One way to measure the quality of life of hepatitis C patients is using health utilities. Health utilities provide insight into not only the state of a patient’s health but also the strength of preference for that health state. This is a meaningful metric that can be used to measure individual and population-level health as well as conduct cost-utility analysis. Methods: We conducted three studies on health utilities in hepatitis C patients: 1) a systematic review and meta-analysis; 2) a clinical study measuring hepatitis C patients’ health utilities in hospital and community health centre settings; and 3) a population-level health utility study using linked survey and healthcare administrative data. Results: The results of these three studies support the observation that hepatitis C is associated with a reduced quality of life. The meta-analysis found that hepatitis C virus infection is associated with impaired health utility. We observed that experimental study designs yield higher health utilities than observational study designs—an effect not previously documented. We also concluded that more research is needed in socioeconomically marginalized hepatitis C patients. The clinical study attempted to address this gap by recruiting marginalized hepatitis C patients from a community-based program. This study found that marginalized patients attending the community-based program had lower health utilities than patients recruited in hospital settings, where clinical research is most commonly conducted. Lastly, the study using administrative data found that the trends observed in the first two studies held true for a larger population-based sample from across Ontario: those with hepatitis C had a reduced quality of life as measured by health utilities, and socioeconomically marginalized individuals with hepatitis C had even lower health utilities. Conclusion: These three studies extend our understanding of health utilities and quality of life in hepatitis C patients, particularly in the context of marginalized populations who face a disproportionate burden. The utility estimates generated by these studies can be incorporated into cost-utility analyses of hepatitis C programs, including cost-utility analyses assessing different models of care for marginalized hepatitis C patients.

Department dc:contributor.department

Pharmaceutical Sciences

Year dc:date.issued

2023

Author dc:creator

• Saeed, Yasmin

Advisors dc:contributor.advisor

• Krahn, Murray
• Wong, William WL

• health economics
• health utilities
• hepatitis C
• patient preferences
• patient-reported outcomes
• quality of life

Handle dc:identifier.uri

http://hdl.handle.net/1807/131075

OAI identifier oai:identifier

oai:utoronto.scholaris.ca:1807/131075