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HCV and the Cost of Increasing Liver Disease Severity

Posted Jan 07 2013 12:00am

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.

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   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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