Cost burden of hepatitis C virus treatment in commercially insured patients

New direct-acting antivirals (DAAs), introduced in late 2013, are effective for treating chronic hepatitis C virus (HCV) infection but may pose substantial financial burden on patients and health insurers. We examined HCV medication use and costs in a commercially insured population. Retrospective cohort study. We used claims data for 3091 individuals with HCV infection (2012-2015). Outcomes included HCV medication use, inflation-adjusted out-of-pocket (OOP) and health plan spending, and predictors of receiving new DAAs. Cumulatively, 9% of members with a diagnosis of HCV were treated with HCV medications in 2012 and this increased to 32% in 2015. Of 3091, 589 received new DAAs and 80% (n = 465) completed a 12-week treatment regimen. After new DAAs became available, average annual health plan spending on HCV medications increased from $2869 to $16,504 per HCV-diagnosed member (relative change, 475%; 95% CI, 352%-598%), and OOP spending increased from $41 to $94 (relative change, 131%; 95% CI, 15%-247%). Age (being aged 50-64 years [adjusted odds ratio (aOR), 2.13; 95% CI, 1.29-3.53] and being ≥65 years [aOR, 2.01; 95% CI, 1.14-3.55] compared with being