January 02, 2020
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HDV has higher health care, cost burden than HBV

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Hepatitis delta virus has a higher association with health care and cost burden on patients than hepatitis B virus, according to a study by the Rutgers Robert Wood Johnson School of Medicine.

“Measures of health care utilization included the median and the average number of claims per patient for emergency department (ED) visits, inpatient admissions, outpatient visits and pharmaceutical prescriptions,” Mohamed I. Elsaid, MD, from the Rutgers Robert Wood Johnson Medical School in New Brunswick, New Jersey, and colleagues wrote. “We also estimated the prevalence of having at least 1 inpatient admission, [emergency department] visit and outpatient visit for cases and controls.”

To assess the burden associated with HDV diagnosis, researchers collected data on health care use and cost parameters from the Truven Health MarketScan Commercial Claims (MSCC) databases.

Out of 22,655 patients with an HBV diagnosis, 2,734 also had a record of HDV. From those patients, the researchers matched 2,727 patients with chronic HBV patients as controls. Researchers defined an index date for participants as the earliest date of HDV diagnosis for potential cases, or a randomly selected claim date for possible chronic HBV controls. A baseline period was defined for all participants as the 12 months before their respective index dates.

In the unmatched sample, patients with HDV had a higher Charlson Comorbidity Index than patients with HBV alone (1.21 vs. 0.89).

The total number of claims was significantly higher in the post-HDV period than the pre-HDV period (25.61 vs. 28.99) and the total health care costs were significantly higher pre-HDV than post-HDV ($19,476 vs. $23,605) in the first HDV diagnosis. In the case-control analysis, there were similar higher total claims (28.99 vs. 25.19) and costs ($23,605 vs. $18,228).

Elsaid and colleagues found that health care use increased in the case-control analysis (3.8 claims) in patients with HDV with a main increase in inpatient admission, ED visits and outpatient activities.

“These findings underscore a need for more effective strategies for the screening, diagnosis and treatment of HDV,” the researchers wrote. “Findings from this study provides the data necessary to assess the cost-effectiveness of potential intervention modalities for HDV.” by Erin T. Welsh

Disclosure: Elsaid reports no relevant financial disclosures. Please see the full study for other authors’ relevant financial disclosures.