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Advances in Treatment and Lower Disease Prevalence of Hepatitis C Has a Large Impact on Medical Plan Costs

Leung, Nina PhD, MPH; Bernacki, Seth E. BA; Bernacki, Edward J. MD, MPH

Journal of Occupational and Environmental Medicine: August 2019 - Volume 61 - Issue 8 - p e354–e357
doi: 10.1097/JOM.0000000000001633
ORIGINAL ARTICLES
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Objective: The aim of this study was to evaluate medical and pharmaceutical costs and health outcomes among commercially insured members treated for hepatitis C virus (HCV) infections from a large, academic institution.

Methods: Data are derived from the University of Texas System (UT SELECT) medical and pharmacy claims database. This study is a retrospective claims analysis of secondary, deidentified data from 2006 to 2016.

Results: The number of HCV-infected and treated patients decreased from 22.5 per 10,000 members in 2006 to 0.15 per 10,000 members in 2016 (P < 0.0001). Medical and pharmacy paid per member per month (PMPM) costs were highest among HCV-infected members with advanced liver disease (total paid PMPM = $2737, medical PMPM = $1537, pharmacy PMPM = $1200).

Conclusions: The declining prevalence of acute HCV infections and the introduction of efficacious HCV treatment options for chronic HCV in this commercial population have resulted in significant reductions in HCV-related medical claims and the clinical sequelae of advanced liver diseases. Although HCV treatment to achieve sustained viral response remains expensive, the prevention of advanced liver disease decreased system-wide medical costs for this insured population.

Dell Medical School, The University of Texas at Austin, Austin, Texas; Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland (Dr Leung and Dr Bernacki); University of the Incarnate Word School of Osteopathic Medicine, San Antonio, Texas (Mr Bernacki).

Address correspondence to: Nina Leung, PhD, MPH, Dell Medical School, The University of Texas at Austin, 1601 Trinity Street, Stop Z0200, Austin, TX 78712-1850 (Nina.Leung@austin.utexas.edu).

The authors report no conflicts of interest.

Clinical Significance: The declining incidence of acute HCV infections and the introduction of efficacious HCV treatment options for chronic HCV in this commercial population have resulted in significant reductions in HCV-related medical claims and the clinical sequelae of advanced liver diseases. Although HCV treatment to achieve sustained viral response (SVR) remains expensive, the prevention of advanced liver disease decreased system-wide medical costs for this insured population.

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Copyright © 2019 by the American College of Occupational and Environmental Medicine