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

Nina Leung, Seth E. Bernacki, Edward J Bernacki

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)E354-E357
JournalJournal of occupational and environmental medicine
Volume61
Issue number8
DOIs
StatePublished - Aug 1 2019

Fingerprint

Hepatitis C
Hepacivirus
Costs and Cost Analysis
Liver Diseases
Virus Diseases
Therapeutics
Insurance Claim Review
Chronic Hepatitis C
Health Care Costs
Population
Databases
Pharmaceutical Preparations

Keywords

  • Hepatitis C
  • epidemiology
  • health services research

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

@article{d70e36779fc549dcafc9c3407587ab29,
title = "A Success Story: Advances in Treatment and Lower Disease Prevalence of Hepatitis C Has a Large Impact on Medical Plan Costs",
abstract = "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.",
keywords = "Hepatitis C, epidemiology, health services research",
author = "Nina Leung and Bernacki, {Seth E.} and Bernacki, {Edward J}",
year = "2019",
month = "8",
day = "1",
doi = "10.1097/JOM.0000000000001633",
language = "English (US)",
volume = "61",
pages = "E354--E357",
journal = "Journal of Occupational and Environmental Medicine",
issn = "1076-2752",
publisher = "Lippincott Williams and Wilkins",
number = "8",

}

TY - JOUR

T1 - A Success Story

T2 - Advances in Treatment and Lower Disease Prevalence of Hepatitis C Has a Large Impact on Medical Plan Costs

AU - Leung, Nina

AU - Bernacki, Seth E.

AU - Bernacki, Edward J

PY - 2019/8/1

Y1 - 2019/8/1

N2 - 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.

AB - 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.

KW - Hepatitis C

KW - epidemiology

KW - health services research

UR - http://www.scopus.com/inward/record.url?scp=85070657515&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85070657515&partnerID=8YFLogxK

U2 - 10.1097/JOM.0000000000001633

DO - 10.1097/JOM.0000000000001633

M3 - Article

C2 - 31205208

AN - SCOPUS:85070657515

VL - 61

SP - E354-E357

JO - Journal of Occupational and Environmental Medicine

JF - Journal of Occupational and Environmental Medicine

SN - 1076-2752

IS - 8

ER -