Impact of completing chronic hepatitis C (CHC) treatment on post-therapy healthcare cost

Abstract

Background:

Chronic hepatitis C (CHC) is associated with significant economic burden. This study evaluated the healthcare cost alleviation associated with treatment of CHC.

Methods:

Health insurance claims from 60 self-insured US companies were analyzed (01/2001–03/2012). Adult patients with ≥1 CHC diagnosis (ICD-9-CM: 070.44, 070.54), initiating interferon, and with ≥2 dispensings and with ≥48 weeks of follow-up were selected. Patients diagnosed with HIV or who completed only 24 weeks of interferon therapy (a surrogate for CHC genotypes 2 and 3) were excluded from the study. Interferon users were categorized into complete and discontinued therapy cohorts. During the post–48-week treatment period, cohorts were compared for healthcare resource utilization using rate ratios (RRs), as well as healthcare costs using per-patient per-year (PPPY) cost differences.

Results:

A total of 1017 patients who completed and 953 patients who discontinued interferon therapy were identified. Relative to the discontinued therapy cohort, the completed therapy cohort had significantly fewer hospitalizations (RR [95% CI] = 0.74 [0.68, 0.81], p < 0.001), outpatient visits (RR [95% CI] = 0.92 [0.91, 0.93], p < 0.001), and ER visits (RR [95% CI] = 0.93 [0.87, 1.00], p = 0.039), which translated into significantly lower total healthcare costs PPPY (cost difference [95% CI] = $4540 [1570, 7680], p = 0.004) and hospitalization costs (cost difference [95% CI] = $3039 [1140, 5248], p = 0.002). Non–CHC-related costs accounted for 55% and CHC-related costs for 45% of the all-cause cost difference between cohorts.

Limitations:

Claims data may have contained inaccuracies, and genotypes of patients with CHC could not be confirmed. The study consisted of privately insured individuals and may not be generalizable to the entire CHC population.

Conclusion:

Compared to discontinued therapy patients, CHC patients who completed interferon therapy and presumably had a higher rate of achieving SVR were found to have lower levels of healthcare resource utilization and costs post-therapy. The reduction was primarily in costs associated with non–HCV-related comorbidities.

Keywords::

• Chronic hepatitis C
• Interferon
• Healthcare costs
• Health resources

Transparency

Declaration of funding

This research was funded by Janssen Scientific Affairs, LLC, Titusville, NJ.

Declaration of financial/other relationship

FL, DP, PL, and GG are employees of Analysis Group Inc., a consulting company that has received research grants from Janssen Scientific Affairs. NT and AP are employees of Janssen Scientific Affairs. LAB has received research grants from Janssen Scientific Affairs. JME peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgments

Partial results were presented as posters at the 19th International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Annual International Meeting, Montreal, Canada, May 31–June 4, 2014 and at the 2013 HEP DART frontiers in drug development for viral hepatitis, Hawaii, December 8–12, 2013.