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

  • Haruhisa FukudaEmail author
  • Yoshihiko Yano
  • Daisuke Sato
  • Sachiko Ohde
  • Shinichi Noto
  • Ryo Watanabe
  • Osamu Takahashi
Original Research Article



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.


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.


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).


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



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 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.

Compliance with Ethical Standards

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.


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.

Supplementary material

40273_2019_861_MOESM1_ESM.docx (24 kb)
Supplementary material 1 (DOCX 23 kb)


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Health Care Administration and ManagementKyushu University Graduate School of Medical SciencesFukuokaJapan
  2. 2.Division of Gastroenterology, Department of Internal MedicineKobe University Graduate School of MedicineKobeJapan
  3. 3.National Institute of Public HealthSaitamaJapan
  4. 4.St. Luke’s International University Graduate School of Public HealthTokyoJapan
  5. 5.Department of Occupational TherapyNiigata University of Health and WelfareNiigataJapan
  6. 6.Faculty of Health and Social ServicesKanagawa University of Human ServicesKanagawaJapan

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