OBJECTIVES: Baseline characteristics, cost, and healthcare resource utilization(HCRU) of Medicaid-insured patients diagnosed with hepatitis D virus(HDV)/hepatitis B virus(HBV) coinfection and HBV only were assessed.

METHODS: Medicaid-insured patients aged ≥18 years with ≥1 inpatient claim or ≥2 outpatient claims ≥30 days apart for HBV monoinfection or HDV/HBV coinfection were identified 01JAN2015-31DEC2019 using International Classification of Diseases, 9/10^th Revision, Clinical Modification(ICD-9/10 CM) diagnosis, procedure, and National Drug Codes (NDC), from STATinMED RWD Insights all-payer medical and pharmacy claims data. The first HDV or HBV diagnosis date was the index date. Patients with HDV/HBV were required to have had HBV-related care within 12 months pre-index date, (HBV-related diagnosis/procedure claims). All patients had >12 months continuous enrollment pre- and post-index date. Patient characteristics, winsorized cost, and HCRU were assessed for the 12-month follow-up period.

RESULTS: Compared to 25,364 patients with HBV only, 666 patients with HDV/HBV had higher rates of hypertension (44% vs 37%, p<.0001), HIV (16% vs 13%, p=0.0398), substance abuse (32% vs 24%, p<.0001), alcohol use disorder (16% vs 11%, p<.0001), and diabetes (32% vs 23%, p<.0001). The HDV/HBV cohort had significantly higher rates of liver comorbidities (all p<.0001): cirrhosis (31% vs 17%), decompensated cirrhosis (24% vs 11%), hepatocellular carcinoma (5% vs 1%), and liver transplant (4% vs 1%). During follow-up, patients with HDV/HBV had significantly more all-cause HCRU (HDV/HBV vs HBV only, 28.2 vs 19.7, p<.0001), inpatient (8.8 vs 5.0, p<.0001), outpatient (16.8 vs 13.3, p=.0007), and pharmacy (12.7 vs 9.0, p<.0001) visits. Patients with HDV/HBV incurred higher total ($50,642 vs $25,632), inpatient ($17,649 vs $7,624), outpatient ($7,570 vs $5,194), and pharmacy costs ($13,310 vs $8,021; all p<.0001).

CONCLUSIONS: HDV infection significantly increased HCRU and cost burden vs HBV only. Medicaid-insured patients with HDV/HBV coinfection and HBV care pre-HDV diagnosis had higher comorbidity and liver complication rates, more healthcare visits and incurred higher costs.