Related Experiment Video
Updated: Jan 1, 2026
A Competent Hepatocyte Model Examining Hepatitis B Virus Entry through Sodium Taurocholate Cotransporting Polypeptide as a Therapeutic Target
Published on: May 10, 2022
Cost burden of hepatitis C virus treatment in commercially insured patients
Christine Y Lu1, Dennis Ross-Degnan, Fang Zhang
1Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Dr, Ste 401 East, Boston, MA 02215.
Insights
New direct-acting antivirals (DAAs) for hepatitis C virus (HCV) significantly increased treatment rates and health plan costs. Patient out-of-pocket spending remained low, but no immediate financial benefits to health plans were observed.
Area of Science:
- Hepatology
- Pharmacoeconomics
- Public Health
Background:
- Direct-acting antivirals (DAAs) revolutionized hepatitis C virus (HCV) treatment starting in late 2013.
- These highly effective therapies present significant financial challenges for patients and healthcare systems.
- Understanding medication use and associated costs in insured populations is crucial.
Purpose of the Study:
- To analyze the utilization and economic impact of new DAAs for HCV in a commercially insured cohort.
- To identify factors associated with the uptake of these novel HCV treatments.
Main Methods:
- A retrospective cohort study design was employed.
- Claims data from 3091 individuals diagnosed with HCV between 2012 and 2015 were analyzed.
- Key outcomes included HCV medication use, inflation-adjusted spending (health plan and out-of-pocket), and predictors of DAA receipt.
Main Results:
- HCV medication treatment increased from 9% to 32% between 2012 and 2015, with 589 individuals receiving new DAAs.
- Average annual health plan spending per HCV-diagnosed member surged by 475% ($2,869 to $16,504), while patient out-of-pocket costs rose by 131% ($41 to $94).
- Older age (50-64 and ≥65 years) and liver cirrhosis were associated with receiving DAAs, whereas alcohol abuse diagnosis was negatively associated.
Conclusions:
- The introduction of DAAs dramatically increased HCV treatment rates within two years.
- While patient out-of-pocket expenses were minimized, the health plan absorbed nearly all medication costs.
- No short-term financial advantages for health plans were evident from HCV cures during the study period.
Objectives:
New direct-acting antivirals (DAAs), introduced in late 2013, are effective for treating chronic hepatitis C virus (HCV) infection but may pose substantial financial burden on patients and health insurers. We examined HCV medication use and costs in a commercially insured population.
Study Design:
Retrospective cohort study.
Methods:
We used claims data for 3091 individuals with HCV infection (2012-2015). Outcomes included HCV medication use, inflation-adjusted out-of-pocket (OOP) and health plan spending, and predictors of receiving new DAAs.
Results:
Cumulatively, 9% of members with a diagnosis of HCV were treated with HCV medications in 2012 and this increased to 32% in 2015. Of 3091, 589 received new DAAs and 80% (n = 465) completed a 12-week treatment regimen. After new DAAs became available, average annual health plan spending on HCV medications increased from $2869 to $16,504 per HCV-diagnosed member (relative change, 475%; 95% CI, 352%-598%), and OOP spending increased from $41 to $94 (relative change, 131%; 95% CI, 15%-247%). Age (being aged 50-64 years [adjusted odds ratio (aOR), 2.13; 95% CI, 1.29-3.53] and being ≥65 years [aOR, 2.01; 95% CI, 1.14-3.55] compared with being <30 years) and having liver cirrhosis (aOR, 3.34; 95% CI, 2.64-4.21) were positively associated with receiving new DAAs, and a diagnosis of alcohol abuse (aOR, 0.70; 95% CI, 0.53-0.92) was negatively associated with receiving new DAAs.
Conclusions:
The proportion of a commercially insured population with HCV infection who were treated with HCV medications doubled within 2 years following availability of new DAAs. Member OOP spending was kept low while the health plan bore 99% of the cost of HCV medications. During our 2-year follow-up, we did not observe financial benefits to the health plan of the cure of HCV infection by new DAAs.
Related Concept Videos
01:26Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow
01:08Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment
01:26Diseases of the Liver and Gallbladder
Cirrhosis is characterized by the scarring of hepatic lobules in the liver, which are replaced by fibrous tissue, affecting the liver's normal functioning. NAFLD, on the other hand, is caused by an excessive build-up of fat in the liver, not...
01:22Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
01:29Chronic Pancreatitis II: Collaborative Care
Assessment:
01:16Hepatic Drug Excretion: Influencing Factors