RT Journal Article SR Electronic T1 The societal burden of chronic liver diseases: results from the COME study JF BMJ Open Gastroenterology FD BMJ Publishing Group Ltd SP e000025 DO 10.1136/bmjgast-2014-000025 VO 2 IS 1 A1 Luciana Scalone A1 Stefano Fagiuoli A1 Roberta Ciampichini A1 Ivan Gardini A1 Raffaele Bruno A1 Luisa Pasulo A1 Maria Grazia Lucà A1 Francesco Fusco A1 Laura Gaeta A1 Anna Del Prete A1 Giancarlo Cesana A1 Lorenzo Giovanni Mantovani YR 2015 UL http://bmjopengastro.bmj.com//content/2/1/e000025.abstract AB Objective Chronic liver diseases (CLDs) impose a significant socioeconomic burden on patients and the healthcare system, but to what extent remains underexplored. We estimated costs and health-related-quality-of-life (HRQoL) among patients with CLDs at different stages and with different aetiologies.Design A cost-of-illness study was conducted. Direct costs, productivity loss and HRQoL were estimated in patients with chronic hepatitis, cirrhosis hepatocellular carcinoma (HCC) or where orthotopic liver transplantation (OLT) had been performed, for hepatitis C virus (HCV) infection, hepatitis B virus (HBV) infection, or in those with liver disease from other causes. Patients were retrospectively observed for 6 months. The societal perspective was adopted to calculate costs.Results In total, 1088 valid patients (median age=59.5 years, 60% men) were enrolled. 61% had chronic hepatitis, 20% cirrhosis, 8% HCC and 12% underwent OLT. HCV infection was identified in 52% and HBV infection in 29% of the patients. Adjusted mean direct costs increased from <€200/patient-month in HCV-infected patients with hepatitis to >€3000/patient-month in HBV infected patients with OLT. Antiviral treatment was the cost driver in patients with hepatitis, while hospital costs were the driver in the other subgroups. Absenteeism increased from HBV-infected patients with hepatitis (0.7 day/patient-month) to patients with OLT with other aetiologies (3.7 days/patient-month). HRQoL was on average more compromised in cirrhosis and patients with HCC, than in hepatitis and patients with OLT. HBV-infected patients generated higher direct costs, patients with other aetiologies generated the highest productivity loss and HCV-infected patients reported the worst HRQoL levels.Conclusions The present study can be considered a benchmark for future research and to guide policies aimed at maximising the cost-effective of the interventions.