OBJECTIVES: To estimate the healthcare resource utilization and direct medical costs among chronic hepatitis C patients in China.

METHODS: A retrospective observational database study was conducted based on inpatient and outpatient visit claim records of Urban Basic Medical Insurance. Patients with chronic hepatitis C diagnosis during 2013-2015 were identified. Exclusion criteria were: 1) <12 years old; 2) complicated with any cancer except hepatocellular carcinoma (HCC). Among the study population, adult patients were separated into 3 subgroups including: 1) HCC group: patients complicated with HCC; 2) Cirrhosis group: patients complicated with cirrhosis but not with HCC; 3) Hepatitis C group: patients complicated with neither cirrhosis nor HCC. Healthcare resource utilization and direct medical costs were analysed. Results reported here focused on the hepatitis C group.

RESULTS: 2,529 patients were eligible for this analysis. The mean age was 46.3±13.9 years. 56.2% were male. For all-cause and hepatitis C related hospitalizations, the admission proportions in tertiary hospitals were 76.1% and 75.3%. The median total costs per hospitalization were $826.9 and $827.5 with a median length of stay of 9 and 10 days separately. More than 70% of the total costs were reimbursed. Medication costs made up ≥ 70% of the total. Long-acting interferon costs made up 56.8% and 67.6% of the medication costs with the usage frequency of 70.0% and 47.7%. As for all-cause and hepatitis C related inpatients, tertiary hospitals were also the major visit institution (53.5% and 70.7%). The median costs per visit were $41.8 and $125.8, more than 60% of which covered by insurance. Long-acting interferon costs made up 47.4% and 82.0% of the medication cost with the usage frequency of 11.3% and 40.7% separately.

CONCLUSIONS: Among chronic hepatitis C patients in China, tertiary hospitals are the major healthcare institution. Medication costs, especially long-acting interferon costs are dominated in the direct medical costs.