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HCV Cost Burden: medical costs; treatment costs; work productivity losses & savings; HCC mortality has tripled, cirrhosis has doubled. NYS Restrictions below. CMS/Feds Letter to Medicaids
  NOW CMS letter to state medicaid's requests removing restrictions.....http://www.natap.org/2015/HCV/110615_01.htm but will the state medicaids comply & will the feds really enforce this, remains to be seen. The letter from CMS has strong language that state medicaid's should remove restrictions while at the same time there is wriggle room in the letter for the states.
Jules Levin, NATAP
Numerous studies have estimated the medical burden, here are just a few studies, an estimate of medical costs could be said to be $110 Bill over the next 10 years. This does NOT include indirect medical costs for extraheptic manifestations, which include diseases that HCV can cause including diabetes, renal disease, heart disease and others, nor does this $110 Bill include work productivity lost due to HCV......not treating CHC patients is expected to result in $7.11 billion of lost productivity costs annually........savings from treatment range from $2.9 to $4.4 Billion per year: http://www.natap.org/2015/DDW/DDW_17.htm......http://www.natap.org/2014/AASLD/AASLD_61.htm........If you do a quick calculation of 3 million with HCV x $45,000 that equals $135 Bill. The VA with discount pays $35,000 per treatment.
HCV+ suffer from conditions that impact physical functioning and work productivity: http://www.natap.org/2014/DDW/DDW_06.htm
Payers would need $136 billion to cover drug costs for all treatment-eligible patients with HCV during the next 5 years, $61 billion of which would need to be paid by the government (Figure 1).......http://www.natap.org/2015/HCV/031815_01.htm
Treating patients at all disease stages: up-front treatment costs would exceed $150 billion.......could generate $610-$1,221 billion in additional quality-adjusted life-years, plus an additional $139 billion in saved medical expenditures over fifty years [$115 Bill over 10 yrs from 2015-2025 according to study immediately below] , and minimize the disease burden.......http://www.natap.org/2015/HCV/101515_01.htm
We estimate that the aggregate US annual incremental cost of HCV in the absence of a cure will total $115 billion over the 2015 to 2025 forecast period.....http://www.natap.org/2015/HCV/092515_03.htm
HCV Hospitalization Costs.....http://www.natap.org/2015/HCV/102115_02.htm......total nationwide charges for hospitalizations with hepatitis C as the principal diagnosis......and more than tripled during the study period (291 percent). increased from $0.9 billion during 2004-05 (20,963 hospitalizations at $42,415 per hospitalization) to $3.5 billion
(64,867 hospitalizations at $53,626 per hospitalization) during 2010-11....... the estimated nationwide charges from the 663,114 hospitalizations principally caused by advanced liver disease totaled $69.4 billion during 2010-11 (an average of $34.7 billion per year), which resulted in a relative percent change of 44 percent when compared with 2004-05.....A recent study also investigated the burden of hepatitis C in the health care system and reported the inpatient burden to be greater than $15 billion annually
Cirrhosis Doubled; Deaths Due to Cirrhosis increased 50%; HCC incidence increased 2.5 fold; HCC mortality tripled - (11/05/15) .....Cirrhosis prevalence nearly doubled from 2001 to 2013......an increase of 59%......HCC incidence was 2.5-fold increased.....HCC mortality tripled
SVR Clears/Reduces Extrahepatic Manifestations - (11/05/15) ,.......this review discusses the many extra hepatic manifestations of HCV including heart disease, NHL/cancer, neurologic & the brain, touches on kidney disease, mixed cryoglobulinemia (MC)....and describes how SVR reduces or clears these disease and improves overall survival.....association of HCV with atherosclerosis, rates of cardiovascular events and mortality may be elevated among HCV-infected patients..... HCV seropositivity was identified as an independent predictor of coronary artery disease, with an odds ratio (OR) of 4.2 (95% confidence interval [CI], 1.4-13.0).....The HCV viral load is independently associated with carotid atherosclerosis, suggesting a causal link between the level of HCV infection and atherosclerotic changes......successful suppression of HCV RNA during treatment and eradication after treatment with interferon-based therapy was associated with improvements in the baseline myocardial perfusion defects
Study suggests unprecedented 3-week hepatitis C cure - (11/05/15)
Here are the restrictions presented at DURB hearing Feb 26 2015 - Clinical Criteria in NYS including the language on healthcare providers: who can treat: "experienced & trained in the treatment of HCV or if under the direct supervision of a specialist"....NYS does "not require abstinence"....."57,000 in NYS have HCV" who receive medicaid, do the math 57,000 x $45,000 = $2.5 bill, we know that all will not be treated in one year but this is the total bill to cure all, we also know some will fail so there will be some pretreatment.
Videocast at DURB Feb 26 Medicaid NYS Hearing.......http://www.natap.org/2015/HCV/031015_02.htm
NYS DURB Hearing on Harvoni Criteria Nov 20 2014 in Albany, NY.......http://www.natap.org/2014/HCV/112114_02.htm


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