As the baby boomer population ages and the silent epidemic of hepatitis C—heavily concentrated in this age group—wreaks havoc on millions of livers, the United States will see a peak of both liver disease and associated health care costs during the next two decades, according to a new report published in the journal Hepatology. The study assumed no incremental rise in treatment rates as a consequence of newer direct acting antiviral therapies.
Among the study’s projections were:
- The prevalence of cirrhotic patients is expected to peak in 2015 with 626,500 cases.
- The prevalence of decompensated cirrhosis should peak in 2019 with 107,400 cases.
- Cases of the liver cancer hepatocellular carcinoma (HCC) will increase to 23,800 cases in 2018 and then decline.
- Active treatment of hepatitis C virus (HCV) can substantially reduce new infections: If the number of people treated for hep C is doubled to a constant rate of 126,000 per year between 2012 and 2030 and the average sustained viral load (SVR, considered a cure) is increased to 70 percent, by 2030 there will be fewer than 100,000 cases of HCV left in the U.S. (Down from the current estimated 2.5 million cases.)
- Mortality from the disease will increase steadily and peak around 2020.
- In 2011, the total U.S. health care cost for hep C was $6.5 billion. This burden should peak in 2024 at $9.1 billion, mostly as a result of liver disease: 46 percent of the cost is due to decompensated cirrhosis, 20 percent to compensated cirrhosis and 16 percent to HCC.