Healthcare Resource Utilization and Costs Among Various Disease States in Adults With Hepatitis Delta Virus in Inpatient and Outpatient Settings in the United States
Author(s)
Robert J. Wong, MD, MS1, Robert G. Gish, MD2, Chong H Kim, MPH, MS, PhD3, Gary Leung, PhD4, Ira M. Jacobson, MD5, Joseph K. Lim, MD6, Marvin Rock, MPH, DrPH3.
1Stanford University School of Medicine, Stanford, CA, USA, 2Robert G. Gish Consultants, LLC, San Diego, CA, USA, 3HEOR-Global Value and Access, Gilead Sciences, Inc., Foster City, CA, USA, 4RWE-Epidemiology, Gilead Sciences, Inc., Foster City, CA, USA, 5NYU Grossman School of Medicine, New York, NY, USA, 6Yale University School of Medicine, New Haven, CT, USA.
1Stanford University School of Medicine, Stanford, CA, USA, 2Robert G. Gish Consultants, LLC, San Diego, CA, USA, 3HEOR-Global Value and Access, Gilead Sciences, Inc., Foster City, CA, USA, 4RWE-Epidemiology, Gilead Sciences, Inc., Foster City, CA, USA, 5NYU Grossman School of Medicine, New York, NY, USA, 6Yale University School of Medicine, New Haven, CT, USA.
OBJECTIVES: Hepatitis delta virus (HDV) infection increases the risk of cirrhosis, hepatocellular carcinoma (HCC), liver transplant (LT), and mortality vs hepatitis B virus (HBV) monoinfection. This study evaluated health care resource utilisation (HCRU) and costs in adults with HDV across levels of disease severity in inpatient and outpatient settings in the US.
METHODS: Adult patients in the PharMetrics database with ≥1 inpatient or ≥2 outpatient claims (ICD-9-CM or exemption codes) ≥30 days apart with an HDV diagnosis on or after the HBV index date (first HDV diagnosis claim between 01/01/2007 and 31/05/2023 with ≥12 months of continuous enrolment pre-index and 1 day post-index date) within the study period (01/01/2006-31/05/2024) were identified. Mean per-patient per-month (PPPM) HCRU and costs were assessed for noncirrhotic disease (NCD), compensated cirrhosis (CC), decompensated cirrhosis (DCC), HCC, and LT. Descriptive statistics were summarised; comparisons were made using Mann-Whitney U and chi-square tests.
RESULTS: Among 12,533 patients, 902 were included. Patients had a mean (SD) age of 48 (11.1) years. The proportions of patients within each disease state at baseline were NCD, 622/902 (69%); CC, 51/902 (6%); DCC, 155/902 (17%); HCC, 43/902 (5%); and LT, 31/902 (3%). Mean all-cause length of inpatient stay (days) and number of outpatient visits were higher for patients with DCC (1.4 and 1.2), HCC (1.3 and 1.5), and LT (5.7 and 1.4) than for patients with NCD (0.4 and 1.1; all P<.0001); mean number of outpatient visits for CC was 3.0 (P<.05). Mean all-cause total costs PPPM were higher with CC ($7,406.38), DCC ($21,895.07), HCC ($5,009.89), and LT ($7,853.84) than with NCD ($3,704.11; all P<.05).
CONCLUSIONS: In the US, patients with HDV with cirrhosis have higher HCRU and costs compared to those with NCD, emphasising the need for earlier diagnosis and treatment of HDV to mitigate disease progression and reduce HCRU and costs.
METHODS: Adult patients in the PharMetrics database with ≥1 inpatient or ≥2 outpatient claims (ICD-9-CM or exemption codes) ≥30 days apart with an HDV diagnosis on or after the HBV index date (first HDV diagnosis claim between 01/01/2007 and 31/05/2023 with ≥12 months of continuous enrolment pre-index and 1 day post-index date) within the study period (01/01/2006-31/05/2024) were identified. Mean per-patient per-month (PPPM) HCRU and costs were assessed for noncirrhotic disease (NCD), compensated cirrhosis (CC), decompensated cirrhosis (DCC), HCC, and LT. Descriptive statistics were summarised; comparisons were made using Mann-Whitney U and chi-square tests.
RESULTS: Among 12,533 patients, 902 were included. Patients had a mean (SD) age of 48 (11.1) years. The proportions of patients within each disease state at baseline were NCD, 622/902 (69%); CC, 51/902 (6%); DCC, 155/902 (17%); HCC, 43/902 (5%); and LT, 31/902 (3%). Mean all-cause length of inpatient stay (days) and number of outpatient visits were higher for patients with DCC (1.4 and 1.2), HCC (1.3 and 1.5), and LT (5.7 and 1.4) than for patients with NCD (0.4 and 1.1; all P<.0001); mean number of outpatient visits for CC was 3.0 (P<.05). Mean all-cause total costs PPPM were higher with CC ($7,406.38), DCC ($21,895.07), HCC ($5,009.89), and LT ($7,853.84) than with NCD ($3,704.11; all P<.05).
CONCLUSIONS: In the US, patients with HDV with cirrhosis have higher HCRU and costs compared to those with NCD, emphasising the need for earlier diagnosis and treatment of HDV to mitigate disease progression and reduce HCRU and costs.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE486
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Infectious Disease (non-vaccine)