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Costs of Hepatitis C
J. Paul Leigh, PhD;
Christopher L. Bowlus, MD;
Bruce N. Leistikow, MD, MS;
Marc Schenker, MD, MPH
Arch Intern Med. 2001;161:2231-2237.
Objective To estimate the direct and indirect costs of the hepatitis C virus (HCV)
in the United States in 1997.
Design Aggregation and analysis of national data sets collected by the National
Center for Health Statistics, the Health Care Financing Administration, and
other government bureaus and private firms. To estimate costs, we used the
human capital method, which decomposes costs into direct categories, such
as medical expenses, and indirect categories, such as lost earnings and lost
home production. We consider HCV that results in chronic liver disease separate
from HCV that results in primary liver cancer.
Results We estimate $5.46 billion as the cost of HCV in 1997. Costs are split
as follows: 33% for direct and 67% for indirect costs. Hepatitis C virus that
results in chronic liver disease contributes roughly 92% of the costs, and
HCV that results in primary liver cancer contributes the remaining 8%. The
total estimate of $5.46 billion is conservative, because we ignore costs associated
with pain and suffering and the value of care rendered by family members.
Conclusions To our knowledge, only one estimate of the annual costs of HCV in the
1990s has appeared in the literature, $0.6 billion. However, that estimate
was not supported by an explanation of the methods. Our estimate, which relies
on detailed methods, is nearly 10 times the original estimate. Our estimate
of $5.46 billion is on a par with the cost of asthma ($5.8 billion [1994]).
From the Center for Health Services Research in Primary Care (Dr Leigh)
and the Department of Internal Medicine (Dr Bowlus), University of California
at Davis Medical Center, Sacramento, Calif; and the Department of Epidemiology
and Preventive Medicine, School of Medicine, University of California at Davis
(Drs Leigh, Leistikow, and Schenker).
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