Mitra D, Davis KL, Medjedovic J, Beam C, Rustgi V. The economic burden of hcv and hbv co-infection: evidence from United States managed care data. Poster presented at the 2008 ISPOR 11th Annual European Congress; November 2008. Athens, Greece. [abstract] Value Health. 2008 Nov; 11(6):A440.

OBJECTIVES: Chronic Hepatitis C virus (HCV) and Hepatitis B virus (HBV) are the two leading causes of liver disease in the world. Approximately 2%-10% of HCV patients worldwide are estimated to also have HBV, resulting in greater disease burden. We analyze insurance claims to assess resource use and costs among managed care enrollees with chronic HCV and HBV co-infection compared to those with chronic HCV alone.

METHODS:AUS claims database spanning the period January 1, 2002 to December 31, 2006 was retrospectively analyzed. Patients were classified into 2 groups: 1) chronic HCV without HBV or HIV (N = 27,296), and 2) chronic HCV and HBV co-infection without HIV (N = 2,525). An index date was set as the date of the first observed chronic HCV diagnosis or date of diagnosis of co-infection. Patients had continuous plan enrollment for >= 3 months pre- and >= 12 months post-index. Mean per patient use and costs of all medical and pharmacy services were assessed over 12 months post-index.

RESULTS: Patients with HCV alone had 61 encounters and total cost of $20,258 compared to 67 encounters and total cost of $23,494 for co-infected patients (P < 0.05). Hospitalization rates were similar across the groups but, per patient hospital costs were more than $2000 greater for co-infected patients (P < 0.05). Co-infected patients stayed longer in the hospital (9.2 vs. 7.6 days, P < 0.05) and also had higher costs for laboratory services and other outpatient/ ancillary services (both P < 0.05). There were no significant differences in encounters and costs related to physician office and emergency department visits. After controlling for demographics and comorbidities in multivariate analyses, co-infected patients had 4.4 more encounters and incurred $1885 more in total costs compared to those with HCV alone (P < 0.05).

CONCLUSIONS: Chronic HCV and HBV co-infection leads to significantly greater consumption of health care resources and imposes greater burden on managed compared to chronic HCV alone.

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