Grant: Project Grant

Hepatitis C virus (HCV) has been identified as having the highest health burden of any infectious disease pathogen. Direct-acting antiviral agents (DAAs) are new drugs that offer the promise of cure and substantially improved tolerability. Because of the expense of these DAAs, and the large number of untreated people, access to DAAs is arguably the most challenging drug reimbursement problem in developed countries in 2016. A critical, but missing, part of the evidence required to formulate HCV treatment policy relates to patient perspectives. We propose to measure the patient burden of HCV. Measuring patient burden involves measuring health related quality of life, the effect of HCV on workplace productivity, and costs to patients. We will interview two groups of patients in two hospitals and two community clinics in Calgary, Toronto and Montreal. The two groups of patients include patients who are being treated with one of the new drugs, and patients who have late-stage Chronic hepatitis C (CHC). Patients will fill out questionnaires and answer questions about their quality of life, out-of-pocket costs, and time they spend on CHC treatment. We will use these results to determine the costs and benefits (cost-effectiveness) of the new drugs in patients with CHC, and to evaluate the cost-effectiveness of screening people in Canada for CHC. The information from our study will play a critical role in determining whether new drugs are offered to patients with CHC. It will be used by a national agency and provincial drug formularies to guide these critical and expensive decisions. The results of our study will also play a critical role in guiding decisions around CHC screening.