Direct Economic Burden of Chronic Hepatitis C Virus in a United States Managed Care Population

Abstract
Goals and Background To estimate all-cause and disease-related resource utilization and costs among managed care enrollees with chronic hepatitis C virus (HCV). Study A large United States claims database was analyzed (1/1/2002 to 12/31/2006). Inclusion criteria were: diagnosis of chronic HCV; no hepatitis B diagnoses; ≥6 and ≥12 months of continuous plan enrollment prediagnosis and postdiagnosis, respectively. Use and costs of medical services and prescription drugs over a 12-month period postdiagnosis were evaluated. Outcomes were assessed in controls without HCV matched (1:1) on age, sex, and plan enrollment. All cost estimates were generated using multivariate generalized linear models to adjust for additional covariates and skewness common in health care cost data. Results Of the 20,662 patients who met all inclusion criteria, mean age was 49 years; 61% were male. Adjusted all-cause costs were $20,961 per HCV patient, compared with $5451 per control (PPPPP<0.0001). Conclusions Chronic HCV is a costly disease to managed care organizations. Disease-related costs in HCV exceed all-cause costs in demographically matched controls. Increased efforts in HCV screening and early treatment, particularly before progression to liver cirrhosis, may lead to long-term cost savings in HCV management for managed care systems.

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