Trends in health care resource use for hepatitis C virus infection in the United States

Authors

  • William C. Grant,

    1. Center for Clinical and Genetic Economics, Duke University Medical Center, Durham, NC
    Search for more papers by this author
  • Ravi R. Jhaveri,

    1. Duke Clinical Research Institute, Duke University Medical Center, Durham, NC
    2. Division of Infectious Diseases, Department of Pediatrics, Duke University Medical Center, Durham, NC
    Search for more papers by this author
  • John G. McHutchison,

    1. Duke Clinical Research Institute, Duke University Medical Center, Durham, NC
    2. Divisions of Gastroenterology, Duke University Medical Center, Durham, NC
    Search for more papers by this author
  • Kevin A. Schulman,

    Corresponding author
    1. Center for Clinical and Genetic Economics, Duke University Medical Center, Durham, NC
    2. Divisions of General Internal Medicine, Duke University Medical Center, Durham, NC
    • Center for Clinical and Genetic Economics, Duke Clinical Research Institute, PO Box 17969, Durham, NC 27715
    Search for more papers by this author
    • fax: 919-668-7124

  • Teresa L. Kauf

    1. Center for Clinical and Genetic Economics, Duke University Medical Center, Durham, NC
    2. Department of Medicine, Duke University Medical Center, Durham, NC
    Search for more papers by this author

  • Potential conflict of interest: Nothing to report.

Abstract

Chronic hepatitis C virus (HCV) infection affects approximately 3 million people in the United States and places tremendous demands on the health care system. As many observers have predicted, the disease burden continues to grow as the infected population ages. In this study, we analyzed inpatient data from the Healthcare Cost and Utilization Project, outpatient data from the National Ambulatory Medical Care Survey, and drug data from the Verispan Source Prescription Audit. We examined recent growth in the use of health care resources among HCV patients by age group and found average annual increases of 25% to 30% for hospitalizations, charges, hospital days, and physician visits. Corresponding time-trend coefficients were positive (P < .001). From 1994 to 2001, the HCV burden increased among patients aged 40 to 60 years, reflecting the natural history of disease progression. In sensitivity analysis, HCV outcome growth rates remained significant, unless more than 3 out of 4 cases were initially underreported. Also, patients co-infected with HIV and HCV in 2001 constituted 7.5 times as many hospitalizations and incurred 2.9 times the charges in 1994, relative to all HIV hospitalizations and charges. Our findings highlight the urgency concerning HCV outcomes. In conclusion, as patients continue to age and disease burden progresses, suboptimal decisions regarding HCV treatments will bring increasing opportunity costs for the health care system and society. (HEPATOLOGY 2005;42:1406–1413.)

Ancillary