Regardless of disease stage or the presence of comorbidities, patients with chronic HCV who received anti-HCV therapy had lower health care costs than untreated patients in a recent study.
Researchers evaluated data on per-patient-per-month (PPPM) medical costs incurred between January 2002 and August 2010 by 33,309 patients with chronic hepatitis C, collected from a US private insurance database, with mean follow-up ranging from 609 to 773 days.
Seventy-eight percent of the cohort had noncirrhotic disease (NCD), while 15% had end-stage liver disease (ESLD) and 7% had compensated cirrhosis (CC). Treatment occurred within the 2-year baseline period in 4,111 cases, including 12% each in the NCD and CC groups and 17% of the ESLD group.
Treated patients with NCD had significantly lower mean PPPM total health care costs during follow-up ($900 vs. $1,378 for untreated patients), as did treated patients with ESLD ($3,634 vs. $5,071) (P<.001 for both). Total PPPM costs were numerically but not significantly lower among treated patients with CC ($1,404 vs. $1,795; P<.071).
On multivariate analysis adjusting for demographics, index date and comorbidities, treated NCD patients had significantly lower total (cost ratio=0.646; 95% CI, 0.586-0.712), medical (ratio=0.713; 95% CI, 0.631-0.806) and HCV-related costs (ratio=0.38; 95% CI, 0.329-0.439). Similar results were observed in the ESLD treated group, with ratios of 0.691 (95% CI, 0.579-0.824) for total costs, 0.684 for medical (95% CI, 0.564-0.83) and 0.657 (95% CI, 0.522-0.828) for HCV-related costs. Treated CC patients also had significantly lower HCV-related costs (ratio=0.539; 95% CI, 0.386-0.753).
Stuart C. Gordon
“There is a perception among clinicians and insurance payers that treating chronic hepatitis C infection is costly and may actually be unnecessary among asymptomatic patients or among patients with mild liver disease,” researcher Stuart C. Gordon, MD, Henry Ford Hospital in Detroit, told Healio.com. “The present study dispels that notion, and suggests that curing hepatitis C infection results in lower downstream health care costs.
“We speculate that treating and potentially eradicating hepatitis C infection may result in an improved overall health status that extends beyond liver disease.”
Disclosure: See the study for a full list of relevant financial disclosures.