Economic and Healthcare Burdens of Hepatitis Delta: A Study of Commercially Insured Adults in the United States.

The paucity of data regarding the extent of Hepatitis delta virus (HDV) associated healthcare burden in the United States is an important obstacle to assessing the cost-effectiveness of potential intervention strategies. In this study, we characterized the healthcare utilization and cost burdens of HDV in the US using real-world claims data. We conducted a case-control study using the Truven Health MarketScan® Commercial Claims databases from 2011-2014. A total of 2,727 HDV cases were matched 1:1 by sociodemographic characteristics and comorbidities to chronic Hepatitis b virus (HBV) controls using propensity scores. The HDV group had significantly higher prevalence of substance abuse, sexually transmitted diseases, decompensated cirrhosis, cirrhosis and hepatitis c virus compared to chronic HBV patients. First HDV diagnosis was associated with significant increases in the total number of healthcare claims (25.61 vs. 28.99; P < 0.0001) and total annual healthcare costs ($19,476 vs. $23,605; P < 0.0001) compared to pre-HDV baseline. The case-control analysis similarly indicated higher total claims (28.99 vs. 25.19; P < 0.0001) and healthcare costs ($23,605 vs. $18,228; P < 0.0001) in HDV compared to the HBV alone. Compared to HBV controls, HDV Cases had adjusted Incident Rate Ratio (aIRR) 1.16 (95% CI; 1.10, 1.22) times the total number of annual claims and aIRR 1.32 (95% CI; 1.17, 1.48) times the total annual healthcare cost. HDV is associated with higher healthcare utilization and cost burden than HBV alone, underscoring the need for improved screening and treatment.