Trends in Utilization and Costs Following a Hepatitis C Elimination Initiative.

Area of Science:

• Public Health
• Epidemiology
• Health Policy

Background:

• Expanded screening and treatment options are crucial for hepatitis C virus (HCV) elimination.
• National guidelines and statewide policies can significantly impact HCV prevalence.
• Washington State implemented a comprehensive HCV elimination strategy in July 2019.

Purpose of the Study:

• To analyze trends in HCV screening, prevalence, treatment, and associated costs.
• To evaluate the impact of Washington State's HCV elimination initiative.
• To assess changes before and after the implementation of the statewide strategy.

Main Methods:

• Observational analysis of retrospective claims data from Washington State (January 2017-September 2022).
• Utilized International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) and Current Procedural Terminology codes.
• Employed interrupted time-series analysis to assess trends pre- and post-initiative, using Q2 2019 as a reference.

Main Results:

• HCV screening significantly increased starting in Q3 2020 (+10.5 tests/month/1000 enrollees).
• Chronic HCV prevalence declined by 0.4 cases/1000 enrollees (2019 Q2-2022 Q3).
• Proportion of newly diagnosed cases treated increased to 24.9% by early 2021; monthly costs per case decreased by $520 by Q1 2021.

Conclusions:

• Washington State's HCV elimination initiative, alongside national guidelines and improved treatments, expanded screening.
• The initiative led to increased identification and treatment of HCV cases.
• Overall healthcare costs associated with HCV care significantly decreased.