Economic and Health Care Burdens of Hepatitis Delta: A Study of Commercially Insured Adults in the United States

Abstract

Background and Aims The paucity of data regarding the extent of hepatitis delta virus (HDV) associated health care burden in the United States is an important obstacle to assessing the cost‐effectiveness of potential intervention strategies. In this study, we characterized the health care use and cost burdens of HDV in the United States using real‐world claims data. Approach and Results We conducted a case‐control study using the Truven Health MarketScan Commercial Claims databases from 2011‐2014. A total of 2,727 HDV cases were matched 1:1 by sociodemographic characteristics and comorbidities to chronic hepatitis B virus (HBV) controls using propensity scores. The HDV group had significantly higher prevalence of substance abuse, sexually transmitted diseases, decompensated cirrhosis, cirrhosis, and hepatitis C virus compared to patients with chronic HBV. First HDV diagnosis was associated with significant increases in the total number of health care claims (25.61 vs. 28.99; P < 0.0001) and total annual health care costs ($19,476 vs. $23,605; P < 0.0001) compared with pre‐HDV baseline. The case‐control analysis similarly indicated higher total claims (28.99 vs. 25.19; P < 0.0001) and health care costs ($23,605 vs. $18,228; P < 0.0001) in HDV compared with HBV alone. Compared with HBV controls, HDV cases had an adjusted incident rate ratio of 1.16 (95% confidence interval: 1.10, 1.22) times the total number of annual claims and an adjusted incident rate ratio 1.32 (95% confidence interval 1.17, 1.48) times the total annual health care cost. Conclusions HDV is associated with higher health care use and cost burden than HBV alone, underscoring the need for improved screening and treatment.

Liver Transplantation for Hepatitis D Virus in the United States: A UNOS Study on Outcomes in the MELD Era

“…Hepatitis delta virus (HDV) infection is considered the most severe form of human viral hepatitis infection, associated with a rapid progression to cirrhosis and an increased risk of hepatocellular carcinoma (HCC), mortality, and need to undergo liver transplantation (LT). [1][2][3][4][5] Although previous studies estimate that HDV infection affects about 15-20 million people worldwide (approximately 5% of the hepatitis B virus [HBV]-infected population), more recent studies have reported that this figure could be much higher. 6,7 In the United States, HDV prevalence is not well understood partially due to incomplete testing and reporting.…”

Molecular epidemiology and clinical characteristics of hepatitis D virus infection in Canada

“…The extremely high burden associated with HDV-HBV co-infection, including severe disease, mortality and attendant healthcare costs 49 ). 1 Countries with ≥5% prevalence of HBV were considered endemic (see Table S2).…”

“…The extremely high burden associated with HDV–HBV co-infection, including severe disease, mortality, and attendant healthcare costs 49 reinforce the need to improve and increase HDV screening and entry into care and treatment. With the advent of new therapies for HDV, understanding the national epidemiology and prevalence of HDV is necessary to properly target and fund effective interventions.…”

Low Performance of Hepatitis Delta Virus Testing Among 2 National Cohorts of Chronic Hepatitis B Patients in the United States

“…Hepatitis delta virus (HDV) infection is associated with more aggressive disease progression in patients with chronic hepatitis B (CHB) infection (1)(2)(3)(4)(5)(6)(7). Suboptimal awareness and nonroutine HDV testing among CHB patients persists.…”