OBJECTIVES: Viral hepatitis is a serious public health problem due to the significant healthcare consequences of hepatitis-C (HCV) and hepatitis-B (HBV) in the United States. Since 2009, Food and Drug Administration (FDA) approved a new class of drugs for HCV and two new molecules for HBV. However, limited healthcare burden evidence exists for viral-hepatitis after the introduction of new drugs. Therefore, this study evaluated the marginal healthcare expenditures for viral-hepatitis using the Medical Expenditure Panel Survey (MEPS).

METHODS: This retrospective, cross-sectional study included adults (≥ 18 years) diagnosed with viral-hepatitis from 2011-20 MEPS. The components of healthcare expenditures (2020 inflation-adjusted) included hospital inpatient, ambulatory services, emergency room, prescription medications, dental, and others. Individuals with viral-hepatitis were identified using medical component files (using International Classification of Diseases, (ICD-9) and (ICD-10) codes). Descriptive weighted analyses were used to examine healthcare-related expenditures for patients with viral-hepatitis and those without viral-hepatitis. A two-part model involving probit and a generalized linear model with log-link function was used to estimate the marginal healthcare expenditures for viral-hepatitis adjusting for demographics and comorbidities.

RESULTS: According to the MEPS, 0.49 million patients (95%CI=0.41-0.57, 0.19%) were diagnosed with viral-hepatitis annually, accounting for a prevalence of 0.19%. Most of these viral-hepatitis patients were in the age group of 45-64 years (62.53%), male (54.17%), and white (59.3%). The two-part model revealed that the marginal total healthcare expenditures in patients diagnosed with viral-hepatitis were $17,221.32 (95%CI=$8,933.09-$25,509.55) more compared with those without viral-hepatitis. Further, the mean adjusted prescription medication expenditures for the viral-hepatitis group were $11,214.89 (95%CI=$5,286.91-$17,142.86) higher compared to their counterparts.

CONCLUSIONS: The study found significant healthcare expenditures for the management of viral-hepatitis, with a major proportion attributable to prescription drugs. Therefore, concerted efforts are needed to improve access to prescription medications to improve viral-hepatitis care and to reduce healthcare costs.