Healthcare resource utilization and costs associated with hepatitis A in the United States: a retrospective database analysis.

Aim. To investigate hepatitis A-related healthcare resource use and costs in the US. Methods. The Merative Marketscan Commercial Claims and Encounters database was retrospectively analyzed for hepatitis A-related inpatient, outpatient, and emergency department (ED) claims from January 01, 2012 to December 31, 2018. We calculated the hepatitis A incidence proportion per 100,000 enrollees, healthcare resource utilization, and costs (in 2020 USD). Results were stratified by age, gender, and select comorbidities. Results. The overall hepatitis A incidence proportion was 6.1 per 100,000 enrollees. Among individuals with ≥1 hepatitis A-related claim, the majority (92.6%) had ≥1 outpatient visit related to hepatitis A; 9.1% were hospitalized, and 4.2% had ≥1 ED visit. The mean (standard deviation [SD]) length of hospital stay was 5.2 (8.1) days; the mean (SD) number of outpatient and ED visits were 1.3 (1.3) and 1.1 (0.6), respectively. The incidence proportion per 100,000 was higher among adults than children (7.5 vs. 1.5), individuals with HIV than those without (126.7 vs. 5.9), and individuals with chronic liver disease than those without (143.6 vs. 3.8). The total mean (SD)/median (IQR) per-patient cost for hepatitis A-related care was $2,520 ($10,899)/$156 ($74-$529) with the mean cost of hospitalization was 18.7 times higher than that of outpatient care ($17,373 vs. $928). Limitations. The study data included only a commercially insured population and may not be representative of all individuals. Conclusions. In conclusion, hepatitis A is associated with a substantial economic burden among privately insured individuals in the US.