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April 15, 2020
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Average cost for hepatitis A hospitalization topped $16K in 2017

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The average hospitalization costs for a U.S. patient with outbreak-associated hepatitis A virus infection was more than $16,000 in 2017, according to an analysis by CDC researchers.

“The introduction of hepatitis A vaccine has dramatically changed the epidemiology of hepatitis A in the United States. After vaccine licensure in 1995, hepatitis A incidence declined substantially,” Megan G. Hofmeister, MD, MS, MPH, a physician in the CDC’s Division of Viral Hepatitis, and colleagues wrote.

However, a large multistate outbreak of HAV has been ongoing in the U.S. since 2016, driven by infections associated with people who report drug use or homelessness. According to the new report, from July 1, 2016, through Feb. 7, 2020, state health departments reported more than 31,000 outbreak-associated cases, making it the largest person-to-person HAV outbreak in the postvaccine era, resulting in more than 18,900 hospitalizations.

“As these unprecedented outbreaks continue, we sought to estimate the average direct medical costs per hepatitis A-related hospitalization, which can be used to guide investment in outbreak prevention efforts,” Hofmeister and colleagues wrote.

The average hospitalization costs for a U.S. patient with outbreak-associated hepatitis A virus infection was more than $16,000 in 2017, according to an analysis by CDC researchers.
Source: Hofmeister MG, et al. Emerg Infect Dis. 2020;doi:10.3201/eid2605.191224.

They analyzed data from the 2017 Healthcare Cost and Utilization Project National Inpatient Sample a 20% stratified sample of discharges from U.S. community hospitals and converted the total hospital charges into cost estimates by multiplying total charges with 2017 hospital-specific cost-to-charge ratios. According to the study, the researchers then multiplied the average costs by the number of patients hospitalized for outbreak-associated HAV to generate an estimate of the preventable economic burden of hospitalizations in the ongoing outbreaks.

The study showed that the overall average cost per HAV-related hospitalization in the U.S. in 2017 was $16,232 (95% CI, $15,052–$17,411), with average costs ranging from $12,921 in the West North Central Census Division to $19,680 in the Pacific Census Division. Using these results as a multiplier for the 18,900 hepatitis A hospitalizations between July 1, 2016, and Feb. 7, 2020, Hofmeister and colleagues estimated that hospitalization costs associated with the outbreaks have exceeded $306.8 million as of Feb. 7, 2020.

“Given the high proportion of hospitalized patients during the ongoing hepatitis A outbreaks, we estimated the average hepatitis A-related hospitalization costs to highlight the preventable economic burden of these outbreaks on health care systems and state governments,” the authors concluded. “Our findings underscore the importance of improving hepatitis A vaccination coverage among at-risk adults, in accordance with Advisory Committee on Immunization Practices recommendations.” – by Caitlyn Stulpin

Disclosures: The authors report no relevant financial disclosures.