An Analysis of Health-Related Quality of Life and Medical Cost of Chronic Hepatitis C Patients under Different Treatment Strategies – A Case Study of a Medical Center
Date Issued
2006
Date
2006
Author(s)
Wen, Chung-Yu
DOI
zh-TW
Abstract
The Bureau of National Health Insurance implemented "National Health Insurance experimental plan to strengthen the treatment for chronic hepatitis C patients" on October 1 2003 to enhance the care quality in drugs treatment for hepatitis C patients. The purpose of this study was to analyze, from the societal perspective, the medical cost (including direct cost and indirect cost) and Health-Related Quality of Life (HRQoL) during the period of treatment under different treatment strategies (peginterferon versus interferon). The method of this study was a cross-sectional interview survey. Study sample were 45 patients with chronic hepatitis C who were receiving treatment in a hepatitis research center of a medical center in the northern Taiwan. The medical cost mainly contained claims data provided by the hospital and personal expenses reported by patients according to a structured questionnaire. The HRQoL were measured by asking patients to fill out a structured questionnaire by themselves; the questionnaire contained the Short Form-12 (SF-12), the Fatigue Symptom Inventory (FSI), and the Hospital Anxiety and Depression Scale (HADS).
Major results of this study are as follow:
1. Hepatitis C patients had the mean scores 40.26 in the PCS and 39.58 in the MCS of the SF-12 questionnaire. Their quality of life was lower than that of general people during the treatment. In the fatigue status, patients in the period of treatment were worse in fatigue intensity, duration, and interference with quality of life. The same results were observed in the anxiety and depression status.
2. The patients with peginterferon treatment strategy were significantly worse than interferon treatment strategy in MCS of SF-12, duration of FSI, and depression of HADS.
3. The total medical cost per month was NT$ 27,261 for peginterferon treatment strategy and NT$ 15,145 for interferon treatment strategy. Peginterferon treatment strategy was 1.8 times the cost of the interferon treatment strategy. In terms of insurance claims, the average cost of peginterferon treatment strategy was NT$ 23,666 while it was NT$ 14,125 for interferon treatment strategy. The cost of drugs had the highest proportion of health insurance claims, the cost of drug for peginterferon was NT$ 23,079 and NT$ 13,652 for interferon. In addition, the indirect cost of Peginterferon treatment strategy was NT$ 1,618, and NT$ 77 for interferon.
The difference of the costs of these two strategies was almost two times, and there were significant drugs side effect that decrease the HRQoL. We therefore suggest that we should determine the genetic type of virus before the treatment, so that we can give the suitable drug treatment strategy according to the gene. We not only may let patients obtain more appropriate care, but also will let the Bureau of National Health Insurance reallocate limited resources to persons who need more and can protect patients from suffering side effects if the treatment is not successful.
Subjects
慢性C型肝炎
醫療成本
健康相關生活品質
干擾素
chronic hepatitis C
medical cost
Health-Related Quality of Life
interferon
SDGs
Type
thesis
File(s)![Thumbnail Image]()
Loading...
Name
ntu-95-R91843011-1.pdf
Size
23.31 KB
Format
Adobe PDF
Checksum
(MD5):6255f003a6f4c3e189085a33b1593007