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Estimation of hepatitis C costs in turkey VIA expert opinion: Delphi panel

      Objectives

      The aim of the study is to estimate the cost of Hepatitis C in Turkey through reaching consensus on the current clinical practice, resource use and the course of treatment.

      Methods

      This study uses the Delphi method to reach experts’ consensus on the clinical practices currently being used in Turkey. Delphi method has been widely used in medical areas where empirical data is scarce. The survey developed for this study includes questions to understand the clinical resource use in order to calculate the associated costs. According to the literature, the panelists’ answers are unlikely to change after the second iteration. Similar to theory, a two-iteration panel was needed to reach a consensus in practice. The consensus is then used to calculate the cost of chronic hepatitis C, compensated cirrhosis, decompensated cirrhosis, hepatocarcinoma and liver transplant health states from the payer’s perspective.

      Results

      The Delphi panel included gastroenterologists, infectious diseases specialists and a gastroenterologist with transplantation experience. According to panel consensus, among all of the patients that an expert follows, the rate of patients who need hepatitis C treatment (regardless of diagnosis) is 1% for gastroenterologists and 20% for infectious diseases specialists. 50% of Hepatitis C patients in Turkey are female and the mean age of patients is 50. Approximately 60% of patients are treatment naïve. Approximately 900 liver transplants are performed in Turkey per year and the success rate is around 85%. From the payer’s perspective, the average annual cost (excluding hepatitis C drug costs) of a chronic hepatitis C, compensated cirrhosis, decompensated cirrhosis, hepatocarcinoma and liver transplant patient is USD 446.83, USD 577.56, USD 1984.39, USD 2474.15, USD 42,469.27 respectively.

      Conclusions

      Early diagnosis and treatment is crucial not only from the clinical perspective, but also from the cost perspective as a more severe disease costs significantly more.