In nation’s capital, unreimbursed expenses for patients with HCV, HIV/HCV exceed $30 million

PHILADELPHIA — Viral hepatitis, specifically hepatitis C virus infection, was prevalent among the population in southeastern Washington, D.C., according to data presented at IDWeek 2014.

“The prevalence of hepatitis C infection at our hospital is significant and unexpected,” Joshua Stierwalt, candidate, George Washington University Master of Public Health-Epidemiology, told Healio.com/Hepatology. “Health care expenditures among hepatitis C patients who are publicly insured by Medicaid are significant and warrants consideration to identify opportunities for cost-savings. Efforts are urgently needed to ensure national and local public policies support the cost of care and access to the latest hepatitis C treatment for this population.”

Joshua Stierwalt

Researchers, including Stierwalt and Lisa Fitzpatrick, MD, MPH, of the United Medical Center in Washington, D.C., analyzed the hospital health information system for diagnosis codes matching patients with viral hepatitis between 2009 and 2013 to determine the number of infected patients in the area. Univariate analysis was used to distinguish those seeking hospital-based care at a facility.

During a 5-year period, there were 5,126 visits among 4,752 patients with viral hepatitis; 91% (n=4,665) of patients had HCV, 8% (n=417) had hepatitis B virus, 1% (n=40) had hepatitis A virus and 0.08% (n=4) had hepatitis D virus.

HIV coinfection was present in 11% of patients with HCV (n=474). Among all of the patients monoinfected with HCV, 65% were male, 96% were black and 94% were publicly insured. Of those coinfected, 59% were male, 98% were black and 96% were publicly insured. Treatment status was not available, but researchers found that unreimbursed expenditures were more than expected, Stierwalt said. The expenditures among patients with HCV, both monoinfected and coinfected, that were not reimbursed totaled approximately $36 million, according to the research.

Monoinfected women had $11 million unreimbursed while coinfected women had $2.2 million outstanding. In men, those with only HCV held $19.3 million in expenditures without reimbursement while men with HIV/HCV coinfection had $3.1 million in outstanding expenditures. – by Melinda Stevens

For more information:

Fitzpatrick L. Abstract 1148. Presented at: IDWeek; Oct. 8-12, 2014; Philadelphia.

Disclosure: The researchers report no relevant financial disclosures.