Economic Burden of Hepatitis C-associated Diseases in the United States

A. C. El Khoury; W. K. Klimack; C. Wallace; H. Razavi


J Viral Hepat. 2012;19(3):153-160. 

In This Article

Abstract and Introduction


Summary. There are approximately 100 drugs in development to treat hepatitis C. Over the next decade, a number of new therapies will become available. A good understanding of the cost of hepatitis C sequelae is important for assessing the value of new treatments. The objective of this study was to assess the economic burden data sources for hepatitis C in the United States. A systematic literature search was conducted to identify studies reporting the costs of hepatitis C sequelae in the United States. Over 400 references were identified, of which 50 were pertinent. The costs were compiled and adjusted to 2010 constant US dollars using the medical component of the consumer price index (CPI). The cost of liver transplants was estimated at $201 110 ($178 760–$223 460), hepatocellular carcinoma (HCC) at $23 755–$44 200, variceal haemorrhage at $25 595, compensated cirrhosis at $585–$1110, refractory ascites at $24 755, hepatic encephalopathy at $16 430, sensitive ascites at $2450, moderate chronic hepatitis C at $155, and mild chronic hepatitis C at $145 per year per person. All studies were traced back to a handful of publications in the 1990s, which have provided the basis for all sequelae-based cost estimates to date. Hepatitis C imposes a high economic burden. Most cost analysis is more than 10 years old, and more research is required to update the sequelae costs associated with HCV infection.


Chronic hepatitis C is a leading cause of cirrhosis and hepatocellular carcinoma (HCC) and a major indication for liver transplantation.[1] The burden of the disease is expected to increase in the United States as the hepatitis C virus (HCV)-infected population ages.[2]

There are approximately 3.9 million (MM) HCV-infected persons in the United States and 12 000 die annually from HCV-related liver disease.[3] A high proportion of US patients became infected in the 1960s and 1970s as injection recreational drug users. Now approaching or older than 60 years of age, they represent a cohort that is expected to develop significant liver disease.[4] It is projected that compensated cirrhosis and HCC will increase by over 80 per cent from the year 2000 to the year 2020. Over the same period, it is estimated that decompensated cirrhosis would increase over 100 per cent and that liver-related deaths would increase by 181 per cent.[5]

Understanding the economic burden of diseases relating to HCV infection has value in itself. It is also important as a baseline for policy and resource allocation decisions as well as determining the cost effectiveness of new therapies. Given the wide selection of sources available on this topic, the focus of this study was to systematically review published literature and develop baseline costs for future work on this topic in the United States.


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