The Implications of Better Estimating Hepatitis C Prevalence

Where Do We Go From Here?

By Carol Smyth, MD & Brian Saindon

 

If you are just tuning in, this is the fifth blog post in a five part series exploring Hepatitis C (HCV) prevalence.  Our experts at Medivo have conducted an analysis of HCV+ patients within Medivo’s lab test results database. The goal was to identify gaps, and therefore enable healthcare professionals to better understand Hepatitis C prevalence and incidence in New York, where health officials have published 2014 data. We hope that this blog series helps to inform education and treatment programs to improve patient health.

Last week, we established that the Medivo database captured an additional 11,948 individuals as being newly diagnosed with HCV in New York City and an additional 3,623 individuals as being newly diagnosed with HCV in New York State (excluding NYC) during the 2014 time period as compared to the numbers reported by the New York City Department of Health and Mental Hygiene (NYC DHMH) and the New York State Department of Health (NYS DOH).  Acknowledging that Medivo has identified a larger number individuals diagnosed with HCV suggests that the incidence of HCV in both New York State and New York City is underreported.

Overall Count of HCV+ Past or Present Cases Identified in 2014 in New York City
Using NYC DHMH and Medivo Data

Hepatitis C Prevalence DHMH

Overall Count of HCV+ Past or Present Cases Identified in 2014 in New York State
Excluding NYC Using NYS DOH and Medivo Data

screen-shot-2016-10-21-at-1-52-43-pm

 

The most recently published statistics from both the NYC DHMH and the NYS DOH is for 2014. Since Medivo has access to current HCV laboratory test results, we further looked at these results up to May of 2016, and identified an additional 23,941 and 13,721 new cases of patients diagnosed with HCV in NYC and NYS (excluding NYC), respectively, between January 2015 and May 2016.  At the time of this post, we have not identified any published reports from the NYC DHMH or the NYS DOH to identify similar metrics on newly identified HCV cases across the 2015 or 2016 time periods. We look forward to comparing our findings to the New York HCV data for 2015 and 2016, when it becomes available.

 

Implications

1. HCV is Underreported

Our study identified 15,571 more patients diagnosed with HCV across all of NYS in 2014 as compared to the NYSDOH and NYC DHMH sources.  This indicates that current surveillance measures still result in underreporting of HCV  in New York State and New York City. Knowing that there are more HCV cases, and the number of unidentified cases in public health records, helps to better estimate the amount of HCV treatment needed across NYS.

2. Multiple Data Sources are Better than One

The results of our study suggest that multiple data sources better identify the true burden of HCV.  Using a network of lab partners, Medivo identified 2.6 times the number of HCV patients for 2014 in NYC than reported by the NYC DHMH.  In NYS (excluding NYC), Medivo identified 1.5 times the number of HCV patients for 2014 as reported by the NYS DOH.  

3. Timing is Key

Traditional methods of collecting epidemiological data result in a lag of 2 or 3 years before the data is finally analyzed and published. This means that disease trends are not seen in real time, something that can negatively impact response to disease outbreaks. Rapid identification of newly identified HCV patients can help HCV-diagnosed patients receive treatment more quickly.

4. Finding and Treating HCV+ is Cost Effective

Finding and treating patients early can reduce morbidity and mortality in later years, which can prevent transmission, prevent HCV-related morbidity and mortality, and reduce future health costs. A 2016 analysis by David Sprach suggests that screening the Baby Boomer cohort (people born between 1945 and 1964) for HCV costs about $2400 per case found – but would find more than 800,000 new cases more than traditional risk-based screening. Treating these cases would result in 120,000 fewer deaths due to complications of HCV, at a cost of about $35,000 per quality-adjusted life year saved. Sprach writes that “the cost-effectiveness of hepatitis C birth cohort screening is similar to other widely used screening practices, such as screening for hypertension or colorectal cancer.”

 

Medivo Insights

Increasing data availability in the health sector requires adaptation of companies to use advanced technologies in order to harness the power of data.  Over this blog series, we have synergized Medivo’s clinical and technological capabilities in order to help uncover the story behind Hepatitis C prevalence, and further illuminate a patient’s journey through the disease.

We have leveraged our clinical expertise in order to diagnose individuals with Hepatitis C using clinical lab test results. Additionally, we have generated descriptive statistics on the overall counts using advanced technologies like Amazon web services, Apache Spark and Tableau. Through the use of clinical expertise and advanced technology, we have unlocked the power of clinical diagnostics to showcase Medivo’s capability in Hepatitis C reporting.

 

This is the final blog post in a five part series.   We welcome your comments and feedback regarding any part of this blog series. Please comment below, or reach out to us at info@medivo.com.

 

Sources:
  1. https://www.health.ny.gov/statistics/diseases/communicable/2014/
  2. http://www1.nyc.gov/assets/doh/downloads/pdf/cd/hepatitis-b-and-c-annual-report.pdf
  3. http://www.hepatitisc.uw.edu/go/screening-diagnosis/recommendations-screening/core-concept/all 

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