HCV and the Cost of Increasing Liver Disease Severity

Hepatitis C virus (HCV) infection increases total healthcare costs but the effect of the severity of liver disease associated with chronic hepatitis C (CHC) on healthcare costs has not been well studied. A paper by Gordon et al. (2012) answers this question. The authors stratify patients by liver disease severity–noncirrhotic liver disease (NCD), compensated cirrhosis (CC), and endstage liver disease (ESLD)–using ICD-9 codes as report on OptumInsight claims data from 2002-2010. The authors found that mean all-cause healthcare costs were 32% and 247% higher for patients with CC and ESLD compared to those with NCD. The chart below shows these results visually stratified by cost category.

   The authors also examine cost differentials after accounting for patient characteristics include: age, gender, geographic region/division, index year, Charlson comorbidity score, other HCV-related comorbidities, baseline healthcare utilization, baseline medications, and baseline HCV antiviral treatments. After applying this risk-adjustment model, the authors still find significant cost disparities based on liver severity status.


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