NDLI: Impact of disease severity on healthcare costs in patients with chronic hepatitis C (CHC) virus infection.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Gordon, Stuart C. Pockros, Paul J. Terrault, Norah A. Hoop, Robert S. Buikema, Ami Nerenz, David Hamzeh, Fayez M.
Spatial Coverage	United States
Description	Country affiliation: United States Author Affiliation: Gordon SC ( Henry Ford Health System, Detroit, MI, USA. sgordon3@hfhs.org)
Abstract	UNLABELLED: Hepatitis C virus (HCV) infection increases total healthcare costs but the effect of the severity of liver disease associated with chronic hepatitis C (CHC) on healthcare costs has not been well studied. We analyzed the demographics, healthcare utilization, and healthcare costs of CHC patients in a large U.S. private insurance database (January, 2002 to August, 2010), with at least 1 year of baseline enrollment and 30 days of continuous follow-up. Patients were stratified by liver disease severity: noncirrhotic liver disease (NCD), compensated cirrhosis (CC), and endstage liver disease (ESLD), as defined by the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9) codes. Mean all-cause and HCV-related healthcare costs per-patient-per-month (PPPM) during follow-up (mean 634 days) are reported in 2010 U.S.\$ from the payer's perspective. A total of 53,796 patients with CHC were included (NCD: 41,858 [78%]; CC: 3,718 [7%]; and ESLD: 8,220 [15%]). Mean all-cause PPPM healthcare costs were 32% and 247% higher for patients with CC and ESLD compared to those with NCD (\$1,870 and \$4,931 versus \$1,420; P < 0.001) and were independent of age or comorbid conditions. Pharmacy, ambulatory, and inpatient care collectively accounted for 90% of NCD costs and 93% of CC and ESLD costs. The largest cost components were inpatient costs for those with ESLD (56%) and ambulatory costs for those with CC and NCD (37% and 36%, respectively). Overall, 56% of costs were HCV-related and this proportion increased with severity (46%, 57%, and 71% for patients with NCD, CC, and ESLD, respectively). CONCLUSION: The direct healthcare costs associated with CHC are high, increase in association with the progression of liver disease, and are highest in those with ESLD.
File Format	HTM / HTML
ISSN	02709139
Issue Number	5
Volume Number	56
e-ISSN	15273350
Journal	Hepatology
Language	English
Publisher	Wiley
Publisher Date	2012-11-01
Publisher Place	United States
Access Restriction	Subscribed
Subject Keyword	Discipline Hepatology End Stage Liver Disease Economics Health Care Costs Statistics & Numerical Data Health Services Utilization Hepatitis C, Chronic Liver Cirrhosis Adolescent Adult Aged Ambulatory Care Antiviral Agents Therapeutic Use Databases, Factual Drug Costs Therapy Female Hepacivirus Complications Drug Therapy Hospitalization Humans Insurance, Health Male Middle Aged Retrospective Studies Severity Of Illness Index United States Young Adult Journal Article Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Hepatology

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