Hepatitis C Prevalence and Cost a Greater Burden in Younger Medicare Population

San Francisco—The prevalence of hepatitis C (HCV), including advanced liver disease (ALD), and the costs to treat these conditions increased significantly among Medicare patients >65 years of age, according to information presented during a poster session at the AMCP meeting. The poster was titled Recent Trends in the Prevalence of HCV—Infected Medicare Patients and the Associated Cost Burden.

More than 65% of Medicare patients with HCV are <65, enrolled due to disability, end-stage renal disease, social security retirement, or Railroad retirement benefit. Researchers conducted a study using data from the National Health and Nutrition Evaluation Survey (NHANES) and Medicare claims to estimate the number of HCV-infected patients with and without ALD, and the costs associated with these conditions between 2007 and 2009.

Results showed that there were 1.10 million HCV-infected patients in 2008, of whom approximately 270,000 were enrolled in Medicare. This number grew to 277,000 by 2009, rising from 262,000 in 2007, for an annual growth rate of 2.8%.

The population without ALD increased 2.3% annually, from 211,000 to 221,000. However, the population with ALD grew at a rate of 4.9% annually (from 51,000 to 56,000). Medicare costs associated with treating HCV-infected patients rose at a yearly rate of 3.8%, from $2.79 billion in 2007 to $3 billion in 2009. Costs associated with treating patients without ALD remained stable at approximately $1.7 billion between 2007 and 2009, but treatment costs related to ALD increased from $1.06 billion in 2007 to $1.29 billion in 2009, for an annual growth rate of 10%.

Results also showed total Medicare costs to treat HCV-infected patients <65 years of age increased from $1.94 billion in 2007 to $2.2 billion in 2009, an annual growth rate of 7.1%.

By 2009, patients with ALD accounted for 20.6% of all Medicare patients <65 years of age, with related ALD costs comprising 43.1% of the total costs for the under-65 Medicare population. Among Medicare patients ≥65 years of age, costs related to ALD represented 42.5% of the total costs incurred by that population with HCV.

Medicare patients ≥65 years of age with HCV, but without ALD, were shown to have rates of all-cause mortality that were twice as high as the general Medicare ≥65 years of age population. Patients with cirrhosis had rates of all-cause mortality that were twice as high as those patients without ALD. Those with severe ALD had all-cause mortality rates greater than 25% annually, and approaching or exceeding 50% in the oldest patients.

This study was supported by Vertex Pharmaceuticals Incorporated.