Cost of chronic hepatitis B infection in the United States.

GOALS

To estimate the direct medical costs associated with chronic hepatitis B (CHB) infection in the United States.

BACKGROUND

Approximately 240,000 new cases of hepatitis B infection occur annually in the United States. There are estimated to be 1.25 million sufferers of CHB in the United States. However, the economic impact of these infections has not been well studied.

STUDY

We conducted a retrospective cohort analysis using administrative healthcare claims data to estimate costs for six health states associated with CHB infection. The six states were as follows: 1) CHB, 2) compensated cirrhosis, 3) decompensated cirrhosis, 4) liver transplantation, 5) transplant care >12 months following transplant, and 6) hepatocellular carcinoma. Patients in each health state were identified using diagnostic and procedure codes, and their utilization was tracked during their time in that health state. To estimate costs, we used reimbursed amounts and adjusted to year US 2000 dollars.

RESULTS

Average annual costs for patients in each health state were as follows: CHB, US 761 dollars; compensated cirrhosis, US 227 dollars; decompensated cirrhosis, US 11,459 dollars; liver transplant, US 86,552 dollars; transplant care >12 months following transplant, US 12,560 dollars; and hepatocellular carcinoma, US 7,533 dollars. Medications contributed the largest proportion of costs in CHB and compensated cirrhosis disease states, while hospitalizations were the largest cost component in the other health states.

CONCLUSIONS

This analysis provides estimates of the annual costs of complications of hepatitis B infection in the United States. The most progressive health states were associated with significantly higher costs.