title: Medical resource utilisation and healthcare costs in patients with chronic hepatitis C viral infection and thrombocytopenia.
abstract: BACKGROUND
  Thrombocytopenia is a significant risk for patients with chronic HCV infection and a common side-effect of treatment with pegylated (PEG) interferon (IFN). Thrombocytopenia predisposes patients to bleeding and requirements for platelet transfusions, and may thus place an increased burden on patients and on medical resource utilisation.
  
  
  METHODS
  In a retrospective analysis of an integrated, longitudinal database of medical and pharmacy claims and laboratory results in a US commercial health (insurance) plan, patients with chronic hepatitis C viral (HCV) infection were identified by reviewing ICD-9-CM HCV-, chronic liver disease-, and cirrhosis-related diagnoses. Medical resource utilisation and laboratory results were evaluated during the year following the HCV diagnosis index date as well as during the baseline year prior to that index date. Medical resource utilisation was determined by comparing outpatient visits, emergency department (ER) visits, and inpatient hospital stays for HCV patients with or without thrombocytopenia.
  
  
  RESULTS
  HCV patients diagnosed with thrombocytopenia had a greater incidence of bleeding events (27.3 vs. 9.9%), platelet transfusions (8.5 vs. <1%), liver disease-related ambulatory visits (10.4 vs. 4.4; odds ratio [OR] = 2.3; p < 0.001), ER visits (OR = 8.6; p < 0.01), and inpatient hospital stays (OR = 17.7; p < 0.01) during the study period compared with HCV patients without a thrombocytopenia diagnosis. HCV patients with thrombocytopenia had significantly higher overall healthcare costs ($37,924 vs. $12,174; p < 0.001) and liver disease-related costs ($14,569 vs. $4107; p < 0.001) than patients without thrombocytopenia.
  
  
  CONCLUSIONS
  Administrative claims data are subject to coding errors; additionally, the patient population may not be completely representative of the general chronic HCV population.
  
  
  CONCLUSIONS
  Diagnosis of thrombocytopenia in patients with HCV is associated with increased incidence of certain comorbidities, complications, and medical interventions, and significantly increased medical resource utilisation.
authors.affiliation: Cedars-Sinai Medical Center, Los Angeles, CA; David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
authors.forename: Fred
authors.initials: F
authors.lastname: Poordad
authors.forename: Dickens
authors.initials: D
authors.lastname: Theodore
authors.forename: Jane
authors.initials: J
authors.lastname: Sullivan
authors.forename: Kelly
authors.initials: K
authors.lastname: Grotzinger
mesh_terms: D000998:Antiviral Agents / Q000191:economics* / Q000627:therapeutic use; D001803:Blood Transfusion; D018450:Disease Progression; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006295:Health Resources / Q000706:statistics & numerical data; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy / Q000191:economics*; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D007345:Insurance Claim Review; D007372:Interferons / Q000191:economics / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000706:statistics & numerical data; D010976:Platelet Count; D012044:Regression Analysis; D012189:Retrospective Studies; D012254:Ribavirin / Q000191:economics / Q000627:therapeutic use; D013921:Thrombocytopenia / Q000191:economics* / Q000453:epidemiology / Q000209:etiology; D014481:United States / Q000453:epidemiology
chemical_list: D000998:Antiviral Agents; D012254:Ribavirin; D007372:Interferons