Health care costs associated with chronic hepatitis B

The long-term health care costs of patients with chronic hepatitis B (CHB) were compared with those of patients without CHB. Patients with laboratory markers for CHB were identified from an HMO databa se and matched with up to four control patients (either not tested for hepa titis B infection or with negative test results). Cost data were collected retrospectively for both groups of patients for the period up to 30 days be fore identification of the first marker for hepatitis B (prediagnosis), 30 days before identification of the first marker through 180 days after the i dentification (peridiagnosis), and 181 days after identification through th e end of the six-year study period. Costs were categorized as emergency roo m, inpatient, short-stay inpatient, laboratory, radiology, office visit, ph armacy, outside claim, or other and were analyzed as ratios of the costs of each patient with CHB to the median of the corresponding control patients. Eighty-eight patients were identified as having CHB; there were 342 control patients. In the seven months surrounding the appearance of their first di agnostic marker, the patients with CHB had costs 3.3 times those of the cor responding control patients and, after the first seven months, 2.9 times th ose of the control patients per month. Peridiagnosis costs in the categorie s of laboratory, radiology, office visits, and pharmacy were significantly higher for patients with CHB than for control patients. Except for emergenc y room costs, postdiagnosis costs per month of the patients with CHB were s ignificantly higher than those of the corresponding control patients. Examination of an HMO database showed that, compared with patients without CHB, patients with CHB had significantly higher health care costs around an d after the CHB diagnosis.