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Healthcare Expenditures for the Treatment of Patients Infected with Hepatitis C Virus in Japan

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Abstract

Aim

The recently developed direct-acting antivirals (DAAs) for hepatitis C virus (HCV) infections are costly. Cost-effectiveness analyses of DAAs require accurate healthcare expenditure estimates for the various HCV disease states, but few studies have produced such estimates using national-level data. This study utilized nationally representative data to estimate the healthcare expenditure for each HCV disease state.

Methods

We identified all patients infected with HCV between April 2010 and March 2018 from a nationwide administrative claims database in Japan. Monthly patient-level healthcare expenditures were calculated for the following disease states: chronic hepatitis C (CHC), compensated cirrhosis (CC), decompensated cirrhosis (DC), and hepatocellular carcinoma (HCC). The expenditures for the CHC and CC states were also compared before DAA treatment and after sustained virologic response (SVR) was achieved. A longitudinal two-part model was employed to estimate the healthcare expenditures for each state.

Results

During the study period, 1,564,043 patients with 146,488,137 patient-months of data met the inclusion criteria. The year of valuation was 2017. The mean monthly healthcare expenditures per patient (95% confidence intervals) for the pre-DAA CHC, CC, DC, and HCC states were US$267 (US$267–268), US$428 (US$427–429), US$666 (US$663–669), and US$969 (US$966–972), respectively. The mean monthly healthcare expenditures per patient for the post-SVR (≥ 2 years) CHC and CC states were US$176 (US$176–177) and US$238 (US$236–240), respectively. Healthcare expenditure increased with increasing age in all disease states (P < 0.05).

Conclusions

These healthcare expenditure estimates from a nationally representative sample have potential applications in cost-effectiveness analyses of DAAs.

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Data Availability Statement

The data that support the findings reported here were obtained from the Japanese Ministry of Health, Labour and Welfare under license for the current study, and are not publicly available due to restrictions stipulated by the ministry. However, the data are available from the Ministry of Health, Labour and Welfare upon reasonable request.

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Acknowledgements

We are grateful to Mr. S. Kondo and Mr. S. Yamakawa from Denno Labo Corporation for their support in extracting the study sample from the NDB.

Author information

Authors and Affiliations

  1. Department of Health Care Administration and Management, Kyushu University Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Haruhisa Fukuda

  2. Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan

    Yoshihiko Yano

  3. National Institute of Public Health, Saitama, Japan

    Daisuke Sato

  4. St. Luke’s International University Graduate School of Public Health, Tokyo, Japan

    Sachiko Ohde & Osamu Takahashi

  5. Department of Occupational Therapy, Niigata University of Health and Welfare, Niigata, Japan

    Shinichi Noto

  6. Faculty of Health and Social Services, Kanagawa University of Human Services, Kanagawa, Japan

    Ryo Watanabe

Authors
  1. Haruhisa Fukuda
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  2. Yoshihiko Yano
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  4. Sachiko Ohde
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  7. Osamu Takahashi
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Contributions

HF, YY, DS, SO, SN, RW, and OT contributed to the study’s conception and design; HF carried out the analysis of the data and drafted the manuscript. All authors were involved in the interpretation of the results, as well as in the editing and revision of the manuscript.

Corresponding author

Correspondence to Haruhisa Fukuda.

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Conflict of interest

Haruhisa Fukuda, Yoshihiko Yano, Daisuke Sato, Sachiko Ohde, Shinichi Noto, Ryo Watanabe, and Osamu Takahashi have no conflicts of interest, financial or otherwise, to declare.

Funding

This work was supported by a Grant-in-Aid for Health Sciences Research from the Ministry of Health, Labour and Welfare of Japan (Grant number: H30-Seisaku-Shitei-003) and JSPS KAKENHI Grant number 17H04144.

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Fukuda, H., Yano, Y., Sato, D. et al. Healthcare Expenditures for the Treatment of Patients Infected with Hepatitis C Virus in Japan. PharmacoEconomics 38, 297–306 (2020). https://doi.org/10.1007/s40273-019-00861-x

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  • DOI: https://doi.org/10.1007/s40273-019-00861-x

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