APPENDIX 1 Treatment episode costs

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1: Medical management of chronic infection Resource category Number Unit cost Total Cost Specialist visits 2 112.65 225.30 Pathology   Liver function test 2 19.80 39.60   Alfa fetoprotein 2 19.90 39.80   Ultrasound 1 101.70 101.70 Total 406.40

2: Treatment with interferon (6 months) including workup Resource category Number Unit cost Total Cost Specialist review   initial consultation 1 94.15 94.15   subsequent consultation 6 47.15 282.90 Interferon (allowing for drop out) 0.87 1889.28 1643.67 Pathology   Full blood count 7 17.20 120.40   Liver biopsy 1 130.35 130.35   Liver function test 7 19.80 138.60   International normalisation ratio 1 12.40 12.40   Thyroid function test 3 41.00 123.00   PCR 3 80.00 240.00   Anti-HCV 1 13.70 13.70 Total 2799.17

3: Treatment with interferon (12 months) including workup Resource category Number Unit cost Total Cost Specialist review   initial consultation 1 94.15 94.15   subsequent consultation 14 47.15 660.10 Interferon (allowing for drop out) 0.81 3 755.25 3 041.74 Pathology   FBC 15 17.20 258.00   Liver biopsy 1 130.35 130.35   LFT 15 19.80 297.00   International normalisation ratio 1 12.40 12.40   Thyroid function test 4 41.00 164.00   PCR 6 80.00 480.00   Anti-HCV 1 13.70 13.70 Total 5151.44

4: Management of compensated cirrhosis Resource category Number Unit cost Total Cost GP visits 4 24.50 98.00 Specialist visits   initial 1 110.75 110.75   subsequent 3 55.45 166.35 Pathology   LFT 2 19.80 29.60   AFP 4 19.90 79.60   Ultrasound 2 83.95 167.90 Total 662.20

5: Management of diuretic-sensitive ascites Resource category Number Unit cost Total Cost Inpatient admissions 0.33 1980.00 653.40 Day-only admissions 1 455.00 455.00 Specialist review   initial visit 1 110.75 110.75   subsequent visit 5 55.45 277.25 Pathology   LFT 4 19.80 79.20   Creatinine 4 17.75 71.00   AFP 2 19.90 39.80   FBC 2 17.20 34.40   Prothrombin time 2 12.40 24.80 Medication   Aldactone 200 mg/day 1 99.06 99.06 Procedures   Paracentesis 1 38.20 38.20 Total 1882.86

6: Management of refractory ascites Resource category Number Unit cost Total Cost Day-only admissions 26 455.00 11 830.00 Specialist review   initial visit 1 110.75 110.75   subsequent visit 5 55.45 277.25 Pathology   LFT 4 19.80 79.20   Creatinine 4 17.75 71.00   AFP 2 19.90 39.80   FBC 2 17.20 34.40   Prothrombin time 2 12.40 24.80 Medication   Norfloxacillin 200 mg/tds 0.33 545.15 179.90 Procedures   Paracentesis 26 38.20 993.20 13,640.30

7: Management of variceal haemorrhage - Year 1 Resource category Number Unit cost Total Cost Hospital admission 1 1980.00 1980.00 Day-only admissions 5 455.00 2275.00 Specialist review   initial visit 1 110.75 110.75   subsequent visit 5 55.45 277.25 Pathology   LFT 4 19.80 79.20   Creatinine 4 17.75 71.00   AFP 2 19.90 39.80   FBC 2 17.20 34.40   Prothrombin time 2 12.40 24.80 Medication   Propanolol 1 82.49 82.49 Procedures   Oesophagoscopy (+ anaesthetic) 3 291.95 875.85 Total 5850.40

8: Management of hepatic encephalopathy - Year 1 Resource category Number Unit cost Total Cost Hospital admission 2.4 1980.00 4752.00 Specialist review   initial visit 1 110.75 110.75   subsequent visit 5 55.45 277.25 Pathology   LFT 4 19.80 79.20   Creatinine 4 17.75 71.00   AFP 2 19.90 39.80   FBC 2 17.20 34.40   Prothrombin time 2 12.40 24.80 Medication   Lactulose 60 mls 1 734.96 734.96 Procedures   Diagnostic endoscopy (+ anaesthetic) 1 213.75 213.75   Paracentesis 1 38.20 38.20 Total 6376.11

9: Management of hepatocellular carcinoma - Year 1 Resource category Number Unit cost Total Cost Hospital admission (diagnosis) 1 6947.00 6947.00 Inpatient admission 1 7846.90 7846.90 Specialist visits   initial visit 1 110.75 110.75   subsequent visits 9 55.45 55.45 Pathology   LFT 4 19.80 79.20   Creatinine 4 17.75 71.00   AFP 2 19.90 39.80   FBC 2 17.20 34.40   Prothrombin time 2 12.40 24.80 Procedures   Paracentesis 1 38.20 38.20 Total 8866.60

10: Other hospital admissions Reason for admission/treatment Rate Unit cost ($) Liver transplant (+ associated admissions) 0.02 92,527 Major infection (septicaemia) 0.25 5,300 Terminal care - Advanced liver failure 28,400 - hepatocellular carcinoma 28,400

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