Associated Health Costs - United States
Although few prospective long-term survival and health care cost studies are available for hepatitis C, it has been possible to estimate the life-long economic impact of the disease for both the individual patient and for the U.S. population with chronic hepatitis B. Lifetime health care costs for a patient with chronic hepatitis B has been estimated at $65,000 in the absence of liver transplantation. For the 150,000 HBV carriers with significant liver damage, the lifetime health care costs in the U.S. have been estimated to be $9 billion. Assuming an estimated survival of 25 years, the annual health care costs for the affected U.S. population with chronic hepatitis B is $360 million. Based on the same economic analysis, treatment of chronic hepatitis B with interferon is projected to increase life expectancy by about three years and reduce the aggregate health care costs.
Hepatitis C can only represent a far greater economic cost. While it infects about 3 and a half more times as many people in the United States than does hepatitis B, more than 80% of hepatitis C patients will develop chronic liver disease, as compared to only 20% of hepatitis B patients. Limited data suggest that 15-20% of those with chronic hepatitis C will develop cirrhosis within a five-year period, and as many as 25% may have cirrhosis by 10-20 years. The risk of developing liver cancer is uncertain, but may approach or exceed 1% during the first 20 years of infection and increase thereafter. Hepatitis C is responsible for about one-third of all liver transplants in the United States.
Approximately 1,000 patients are transplanted each year for liver disease due to hepatitis C. With the cost per liver transplantation in the range of $280,000 for one year, liver transplantation for hepatitis C alone reaches a cost of nearly $300 million per year.
Moreover, the average lifetime cost for hepatitis C, in the absence of liver transplant, has been estimated to be about $100,000 for individual patients. Assuming that 80% of the 4.5 million Americans believed to be infected develop chronic liver disease, the total lifetime cost for this group (3.6 million) will be a staggering $360 billion in today's dollars. Assuming an estimated survival of 40 years, the annual health care costs for the affected U.S. population with chronic hepatitis C may be as high as $9 billion.