OBJECTIVES: Trends in health care utilization among HCV patients have demonstrated marked increases between 1994 and 2001, particularly among individuals aged 40 to 60 years. Furthermore, the proportion of treated individuals who achieve disease cure remains relatively low. This has potentially resulted in a large economic burden, as HCV leads to costly liver disease and other morbidity. The objective of this study was to examine trends in HCV-related health care utilization by insurer between 2002 and 2010 in the US. METHODS: Years 2002-2010 of the National Inpatient Sample (NIS) data set of hospital admissions from the Healthcare Cost and Utilization Project (HCUP) were utilized in order to determine the number of adult hospital admissions occurring to HCV-infected patients (identified by ICD-9 codes). These data included a total of 71.7 million hospital admissions from 1,051 US hospitals. The number of admissions occurring to HCV-infected patients was recorded for each year, as well as total charges. Trends over time were compared for three insurers: Medicaid, Medicare, and private. RESULTS: Of the 71 million admissions examined over the study period, 5,350,991 were admissions for HCV-infected adults. More HCV-related admissions were covered by Medicaid and Medicare than private insurance. In 2002, total HCV-related charges were $693M for admissions covered by Medicare, $708M for Medicaid, and $579M for private insurance (costs adjusted to 2010 values). Between 2002 and 2010, total HCV-related charges increased most for Medicare (84%), followed by Medicaid (77%) and private insurance (16%). HCV-related admissions covered by Medicare, Medicaid and private insurance increased commensurately by 84%, 77% and 16%, respectively. CONCLUSIONS: Use of inpatient care for HCV-infected patients has increased rapidly. Increases in the number of HCV patients who seek care, as well as possible increases in the intensity of care and/or escalation in hospital charges has resulted in nearly doubling HCV-related charges from 2002-2010.