Cost Burden of Illness for Hepatitis C Patients with Employer-Sponsored Health Insurance

The disease burden of hepatitis C virus (HCV) is expected to more than double in the next two decades. Currently, there is very little information about the costs of HCV treatment for employers who pay for treatment and health plans that cover HCV patients. This study reports the medical costs of HCV for workers with health insurance. A retrospective claims data design was used for this study. A sample of HCV patients with health insurance was drawn from the inpatient, outpatient, and enrollment files of the MEDSTAT Group's MarketScan family of databases for 1993-1998. Patients were grouped into cohorts and studied for up to 2 years before and after HCV diagnosis. Sample size varies according to length of follow-up, peaking at 3,077 patients enrolled for at least 6 months. In the first year following HCV diagnosis, average payments for HCV patients ($10,925) were almost six times as high as payments for all patients in the MarketScan database ($1,186). Doctors are encouraged to test high-risk patients to find HCV patients earlier in the course of their disease and to better manage their care in order to avoid unnecessary illness and expenses for this disease.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/63140/1/109350702320229195.pd

Retrospective Analysis of the Health-Care Costs of Bupropion Sustained Release in Comparison with Other Antidepressants

AbstractObjectiveThe objective of this study was to evaluate the health care costs associated with the treatment of a new episode of depression with bupropion sustained release (SR) rather than with other antidepressants (selective serotonin reuptake inhibitors [SSRIs], tricyclic antidepressants [TCAs], and serotonin norepinephrine reuptake inhibitors [SNRIs]).MethodsThis was a retrospective cohort study based on the private-pay, fee-for-service 1997 and 1998 MEDSTAT MarketScan databases. Individuals were included if they were 18 years of age or older, had an initial prescription for an antidepressant under study with an index prescription date between July 1997 and June 1998, and had a claim for a diagnosis of depression diagnosis within 30 days of the index date. All patients' claims from six months before and after receiving their index antidepressant prescription were examined. Total, outpatient, and pharmacy costs were compared among antidepressant groups using an intent-to-treat analysis with exponential regression models and bootstrapped 95% confidence intervals.ResultsA total of 1771 patients were included in the study cohort. The mean age was 41.6 years, and 69.5% of subjects were female. Most patients (75%) continued with the index antidepressant during the 6-month follow-up period. Although the drug acquisition cost was lowest for TCAs, total costs were significantly higher for patients treated with TCAs than for those treated with bupropion SR (p < .05). In comparison with bupropion SR, patients initiating therapy with sertraline had significantly higher mental health payments (p < .05).ConclusionsInitiating treatment of depression with bupropion SR was associated with lower total mental health care costs compared with TCAs and with sertraline. This study reaffirms that formulary and medical decision-makers should consider the overall impact of antidepressant treatment, including but not limited to drug acquisition costs, other health care costs, and drug efficacy and safety