Open Access Highly Accessed Research article

The burden of hepatitis C in Europe from the patients’ perspective: a survey in 5 countries

Jeffrey Vietri1*, Girish Prajapati2 and Antoine C El Khoury3

Author Affiliations

1 Health Outcomes Practice, Kantar Health, Independence Way Suite 220, Princeton, NJ, USA

2 AllSource PPS, Long Beach, CA, USA

3 Merck & Co., West Point, PA, USA

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BMC Gastroenterology 2013, 13:16  doi:10.1186/1471-230X-13-16

Published: 17 January 2013



Few studies have examined the impact of Hepatitis C virus (HCV) infection on patient reported outcomes in Europe. This study was conducted to assess the burden of HCV infection in terms of work productivity loss, activity impairment, health-related quality of life, healthcare resource utilization, and associated costs.


The 2010 European National Health and Wellness Survey (n = 57,805) provided data. Patients reporting HCV infection in France, Germany, the UK, Italy, and Spain were matched to respondents without HCV using propensity scores. Outcome measures included the Work Productivity and Activity Impairment (WPAI) questionnaire and the Medical Outcomes Study Short Form-12 (SF-12v2) questionnaire. Subgroup analyses focused on treatment-naïve patients.


HCV Patients (n = 286) had more work impairment (30% vs. 18%, p < .001), more impairment in non-work activities (34% vs. 28%, p < .05), and more annual physician visits per patient (19.8 vs. 13.3, p < .001). Estimated indirect and direct costs were €2,956 (p < .01) and €495 (p < .001) higher than in matched controls, respectively. Health-related quality of life was also lower among HCV patients. Treatment-naïve HCV patients (n = 139) also reported higher work impairment (29% vs. 15%, p < .01), as well as more frequent physician visits (19.5 vs. 12.1, p < .01) than matched controls. Each treatment-naïve HCV infected patient incurred €934 in direct costs vs. €508 (p < .01 in matched controls. Employed treatment-naïve patients reported higher productivity loss per year compared to matched controls (€6,414 vs. €3,642, p < .05).


HCV infection in Europe is associated with considerable economic and humanistic burden. This is also true of diagnosed patients who have never been treated for HCV.

Hepatitis C virus; Absenteeism; Presenteeism; Work impairment; Costs; Health status