studies

286A AASLD ABSTRACTS HEPATOLOGY, October, 2015
Additional resources from government for HCV could aid in the
elimination of HCV from the United States.
Cost of HCV in the era of DAAs
($1.5 billion USD), shielding x-ray components ($13.2 billion
USD), and reducing greenhouse gas emissions ($413 billion
USD). Conclusions: The scope of benefit conferred by new
HCV therapies is large due to the high mortality risk of HCV,
the curative effect of therapy and the size of the population
infected. However, at current prices the incremental cost of
therapy represents a 3478-fold increase in current nationwide
spending on hepatitis C, more than 11% of all national health
expenditures, and 11 times the annual NIH budget. Concurrent
efforts to increase access to treatment as well as reduce drug
costs should be prioritized.
Disclosures:
The following authors have nothing to disclose: Mai T. Pho, Andrew I. Aronsohn,
Benjamin P. Linas, Daniel C. Johnson, Jake R. Morgan, William V. Padula, David
O. Meltzer
Disclosures:
Jagpreet Chhatwal - Consulting: Merck & Co., Inc., Gilead, Complete HEOR
Solutions; Grant/Research Support: NIH/National Center for Advancing Translational
Sciences
The following authors have nothing to disclose: Xiaojie Wang, Mark S. Roberts,
Mina Kabiri, Turgay Ayer, Julie M. Donohue, Fasiha Kanwal
152
Treating Hepatitis C in the US: measuring impact and
value in the context of other major health interventions
Mai T. Pho 1 , Andrew I. Aronsohn 1 , Benjamin P. Linas 2 , Daniel
C. Johnson 1 , Jake R. Morgan 2 , William V. Padula 1 , David O.
Meltzer 1 ; 1 Medicine, University of Chicago, Chicago, IL; 2 Boston
Medical Center, Boston, MA
Background: Hepatitis C (HCV) results in significant morbidity
and mortality in the US. All-oral therapies, while curative, are
costly. We estimate the economic value of providing treatment
for individuals with HCV relative to other major interventions
such as decreasing greenhouse gas emissions. Methods: We
calculate the net monetary benefit (NMB) of therapy provided
for all individuals estimated to be infected with HCV in the US
using a value of statistical life (VSL) and value of statistical life
year (VSLY) framework. A VSL of 5 million US dollars (USD) is
used, and we calculate the VSLY as the quotient of the VSL and
the discounted expected remaining life-years for the general
population. We estimate the total population of HCV based
on prevalence, demographic and genotype data from the
National Health and Nutrition Evaluation Survey from 2003-
2010. The NMB of therapy is the product of VSLY and the
remaining discounted life-years associated with treatment and
no treatment of the total population, subtracted by the incremental
cost. Regimens examined included 12 weeks of sofosbuvir
(SOF) and ledipasvir (LDV) for genotype (GT)1, 12-16
weeks of SOF and ribavirin (RBV) for GT2, and 24 weeks of
SOF and RBV for GT3 infections. Remaining life expectancy
and costs are projected using the Hepatitis C Virus Cost-Effectiveness
(HEP-CE) simulation model. Prices for HCV drugs are
varied from 100% to 55% to reflect offsets due to rebates and
other discounts. Benefits and costs are reported in the context
of federally regulated health interventions. Results: Compared
to no treatment, treating 2.7 million individuals with HCV will
result in 9.5 million life-years gained at an incremental cost of
$347 billion USD. The NMB of HCV therapy is $2.2 trillion
USD. When the price of medications is discounted by 45%,
the NMB of therapy is $2.4 trillion USD, with an incremental
cost of therapy of $187 billion USD. The NMB of HCV
treatment exceeds influenza vaccinations at long-term facilities
153
Hepatitis C (HCV) Infection in Baby Boomers Are Independently
Associated with Mortality and Resource Utilization
Mehmet Sayiner 2 , Mark Wymer 2 , Pegah Golabi 2 , Joel S. Ford 3 ,
Indie Srishord 2 , Zobair M. Younossi 2,1 ; 1 Center For Liver Disease,
Department of Medicine, Inova Fairfax Hospital, Falls Church,
VA; 2 Betty and Guy Beatty Center for Integrated Research, Inova
Health System, Falls Church, VA; 3 Department of Medicine, Inova
Health System, Falls Church, VA
Background and aim: HCV is more common among Baby
boomers (BB) (born 1946-1965). As this cohort age, they will
increasingly become Medicare eligible. Our aim was to evaluate
resource utilization and short term mortality of BB-Medicare
recipients with HCV. Method: We used inpatient and outpatient
Medicare databases (2005-2010) with clinical data,
admission and discharge information, ICD-9 codes, procedure
codes, and billing information. Medicare patients who were
considered BB were identified using all HCV-related ICD-9
codes. Charlson Index was calculated as a measure of comorbidity.
The outcome measures included resource utilizations
[payment per case and inpatient length of stay (LOS)] and short
term mortality (90 days). Results: We included 1,153,862
BB who received Medicare services from 2005 to 2010. Of
these, 3.2% (N=37,365) were HCV (+). During this period,
Medicare-BB in the inpatient setting increased from 39,793 to
55,235, and their claims increased from 78,924 to 106,232.
During the study period, both overall mortality [8.94% to
10.25% (p