شبیه سازی نوآوری با کیفیت مراقبت های بهداشتی بر اساس یک درمان جدید درمان: مورد هپاتیت C در اروپا  Simulating healthcare quality innovation based on a novel medical treatment: The case of Hepatitis-C in  Europe

1. Introduction Hepatitis C Virus (HCV) is not only a worldwide major healthcare issue. In the past year, HCV became the number one topic in healthcare management and health politics. A radical pharmaceutical innovation reanimated the market for HCV medication which promises that N95% of HCV-infected people become virus-free in one treatment period, whereas conventional treatment could only heal about 40–50% of infected individuals (McHutchison et al., 2009; Strader et al., 2004). This might lead to an overall change in the system, including long-term treatment of infected patients, the high need of liver transplantations, or long-term medication demands. Therefore, this innovation can be considered as an overall healthcare quality innovation. Worldwide it is estimated that N185 million people are infected with HCV. The number of infected individuals in Europe is about 10 million. Globally the number of infections is constantly increasing and showed a rise in prevalence and the number of infected people from 1995 to 2005 from 2,3% to 2,8%. Central and East Asia, North Africa and the Middle East are estimated to be countries with a high HCV prevalence, whereas Asia Pacific, Tropical Latin America, and North America have the lowest prevalence rates (Mohd Hanafiah et al., 2013). Although the total number of HCV infections is constant or decreasing in many countries, the burden of the disease is expected to increase (Davis et al., 2010; Deuffic–Burban et al., 2012; Razavi et al., 2013). This is justified by the fact that fewer people get infected although the number of complications which become manifest in a late state of illness increases (Razavi et al., 2014). HCV is caused by infection with the Hepatitis C virus which infects liver cells. About 40% of infected individuals recover from the virus, about 60% become chronic. As a consequence of the disease patients often suffer from a cirrhosis or liver cancer. The disease is classified into 11 genotypes, which have an effect on treatment and chances for healing. Due to their occurrence in Europe and America studies report their findings and information about treatment for genotypes 1–6 (Bruggmann et al., 2014). In Europe the virus is almost exclusively spread by infected needles in the drug scene by receiving infected blood (Hsu et al., 1994; Lemon and Brown, 1995).