Hepatitis C virus therapy is associated with lower health care costs not only in noncirrhotic patients but also in patients with end-stage liver disease

S. C. Gordon, F. M. Hamzeh, P. J. Pockros, R. S. Hoop, A. R. Buikema, E. J. Korner, N. A. Terrault

Research output: Contribution to journalArticle

Abstract

Background The effect of anti-viral treatment on downstream costs for hepatitis C virus (HCV)-infected patients is unknown. Aim To evaluate follow-up costs in patients with chronic HCV, stratified by liver disease severity. Methods Using a US private insurance database, mean all-cause per-patient-per-month (PPPM) US (2010) medical costs were calculated for HCV-infected persons who did and did not receive anti-HCV treatment between January 2002 and August 2010. Analysis was stratified by liver disease severity [noncirrhotic disease (NCD), compensated cirrhosis (CC) or end-stage liver disease (ESLD)] defined by ICD-9 and CPT codes. Results A total of 33 309 patients were included (78% NCD, 7% CC and 15% ESLD); 4111 individuals (12%) received anti-HCV treatment during the 2-year baseline period. Mean PPPM follow-up health care costs were significantly lower among treated patients with NCD ($900 vs. $1378 in untreated patients, P <0.001) and ESLD ($3634 vs. $5071, P <0.001) groups but not in the CC group ($1404 vs. $1795, P <0.071; t-test). In a multivariable model adjusted for demographic characteristics, comorbidities, index date and geographical region, incremental cost ratios for total health care costs differed significantly (P <0.001) between treated and untreated patients in the NCD and ESLD groups but not in the CC group. From this model, mean PPPM total health care costs between treated and untreated patients were $885 and $1370 in the NCD, $1369 and $1802 in the CC, and $3547 and $5137 in the ESLD groups, respectively. Conclusions Anti-HCV therapy was associated with lower follow-up US health care costs, and these savings were independent of baseline patient comorbidities and stage of disease.

Original languageEnglish (US)
Pages (from-to)784-793
Number of pages10
JournalAlimentary Pharmacology and Therapeutics
Volume38
Issue number7
DOIs
StatePublished - Oct 2013
Externally publishedYes

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End Stage Liver Disease
Hepacivirus
Health Care Costs
Fibrosis
Therapeutics
Costs and Cost Analysis
International Classification of Diseases
Comorbidity
Liver Diseases
Current Procedural Terminology
Aftercare
Cost Savings
Chronic Hepatitis C
Insurance
Demography
Databases

ASJC Scopus subject areas

  • Pharmacology (medical)

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Hepatitis C virus therapy is associated with lower health care costs not only in noncirrhotic patients but also in patients with end-stage liver disease. / Gordon, S. C.; Hamzeh, F. M.; Pockros, P. J.; Hoop, R. S.; Buikema, A. R.; Korner, E. J.; Terrault, N. A.

In: Alimentary Pharmacology and Therapeutics, Vol. 38, No. 7, 10.2013, p. 784-793.

Research output: Contribution to journalArticle

Gordon, S. C. ; Hamzeh, F. M. ; Pockros, P. J. ; Hoop, R. S. ; Buikema, A. R. ; Korner, E. J. ; Terrault, N. A. / Hepatitis C virus therapy is associated with lower health care costs not only in noncirrhotic patients but also in patients with end-stage liver disease. In: Alimentary Pharmacology and Therapeutics. 2013 ; Vol. 38, No. 7. pp. 784-793.
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abstract = "Background The effect of anti-viral treatment on downstream costs for hepatitis C virus (HCV)-infected patients is unknown. Aim To evaluate follow-up costs in patients with chronic HCV, stratified by liver disease severity. Methods Using a US private insurance database, mean all-cause per-patient-per-month (PPPM) US (2010) medical costs were calculated for HCV-infected persons who did and did not receive anti-HCV treatment between January 2002 and August 2010. Analysis was stratified by liver disease severity [noncirrhotic disease (NCD), compensated cirrhosis (CC) or end-stage liver disease (ESLD)] defined by ICD-9 and CPT codes. Results A total of 33 309 patients were included (78{\%} NCD, 7{\%} CC and 15{\%} ESLD); 4111 individuals (12{\%}) received anti-HCV treatment during the 2-year baseline period. Mean PPPM follow-up health care costs were significantly lower among treated patients with NCD ($900 vs. $1378 in untreated patients, P <0.001) and ESLD ($3634 vs. $5071, P <0.001) groups but not in the CC group ($1404 vs. $1795, P <0.071; t-test). In a multivariable model adjusted for demographic characteristics, comorbidities, index date and geographical region, incremental cost ratios for total health care costs differed significantly (P <0.001) between treated and untreated patients in the NCD and ESLD groups but not in the CC group. From this model, mean PPPM total health care costs between treated and untreated patients were $885 and $1370 in the NCD, $1369 and $1802 in the CC, and $3547 and $5137 in the ESLD groups, respectively. Conclusions Anti-HCV therapy was associated with lower follow-up US health care costs, and these savings were independent of baseline patient comorbidities and stage of disease.",
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T1 - Hepatitis C virus therapy is associated with lower health care costs not only in noncirrhotic patients but also in patients with end-stage liver disease

AU - Gordon, S. C.

AU - Hamzeh, F. M.

AU - Pockros, P. J.

AU - Hoop, R. S.

AU - Buikema, A. R.

AU - Korner, E. J.

AU - Terrault, N. A.

PY - 2013/10

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AB - Background The effect of anti-viral treatment on downstream costs for hepatitis C virus (HCV)-infected patients is unknown. Aim To evaluate follow-up costs in patients with chronic HCV, stratified by liver disease severity. Methods Using a US private insurance database, mean all-cause per-patient-per-month (PPPM) US (2010) medical costs were calculated for HCV-infected persons who did and did not receive anti-HCV treatment between January 2002 and August 2010. Analysis was stratified by liver disease severity [noncirrhotic disease (NCD), compensated cirrhosis (CC) or end-stage liver disease (ESLD)] defined by ICD-9 and CPT codes. Results A total of 33 309 patients were included (78% NCD, 7% CC and 15% ESLD); 4111 individuals (12%) received anti-HCV treatment during the 2-year baseline period. Mean PPPM follow-up health care costs were significantly lower among treated patients with NCD ($900 vs. $1378 in untreated patients, P <0.001) and ESLD ($3634 vs. $5071, P <0.001) groups but not in the CC group ($1404 vs. $1795, P <0.071; t-test). In a multivariable model adjusted for demographic characteristics, comorbidities, index date and geographical region, incremental cost ratios for total health care costs differed significantly (P <0.001) between treated and untreated patients in the NCD and ESLD groups but not in the CC group. From this model, mean PPPM total health care costs between treated and untreated patients were $885 and $1370 in the NCD, $1369 and $1802 in the CC, and $3547 and $5137 in the ESLD groups, respectively. Conclusions Anti-HCV therapy was associated with lower follow-up US health care costs, and these savings were independent of baseline patient comorbidities and stage of disease.

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