PHOENIX--(BUSINESS WIRE)-- Primrose Healthcare has just launched an innovative calculator tool to help health insurers and other payers uncover and better understand the total costs associated with the hepatitis C virus (HCV) within their populations. The calculator references the data and analysis from the Milliman, Inc. study, “The burden of hepatitis C virus disease in commercial and managed Medicaid populations,” and other user-input assumptions to estimate costs for a payer’s specific population.
While many payers may concentrate on managing anti-viral medication treatment costs, they may not closely focus on the underlying medical cost drivers within the population. The calculator analysis provides payers with a complete picture of typical non-antiviral treatment costs, including prevalence and key cost drivers such as stage of liver disease (i.e. chronic HCV, cirrhosis, etc.), other non-antiviral medication treatment costs and medical costs.
“Calculator analyses run to date clearly show that new medication treatments are not the only reason for high costs among the HCV populations,” said Henri Cournand, CEO of Primrose Healthcare. “Payers focused on medication costs alone are missing out on a valuable opportunity to improve health and reduce per-member-per-month costs related to managing these patients. This really comes to light when you consider that the average annual incremental non-antiviral drug medical costs for an individual with HCV are $21,888—four times higher than those without HCV.”
These costs are driven by the HCV population’s unique characteristics as outlined in the Milliman study. Patients within a commercial population with HCV have:
3-4 times more emergency room (ER) visits
3-4 times greater rates of mental health disorder
5-6 times greater inpatient admission rates
9-10 times greater rate of alcohol dependence and/or alcoholic liver disease
20 times higher rates of drug dependence/abuse
Additionally, the calculator also estimates the “future” costs associated with HCV and liver care. Thanks to advancements in anti-viral medications, many individuals are cured of the virus. However, many of those same patients will suffer from liver damage and require care long after their cure. The calculator breaks down the associated costs based on the disease progression to give payers a clearer picture of their overall healthcare expenses.
Ultimately, the calculator tool—an industry first— is designed to help payers evaluate their existing hepatitis C management program and make decisions to modify or enhance it. To that end, the calculator can model payer-specific results, which can be used to inform their approach to managing individuals with hepatitis C and the associated costs.
According to Cournand, “Payers must develop a consistent approach for HCV patients that should include not just anti-viral medications but also intensive outreach to address comorbidities, poor treatment adherence, behavioral health issues and substance abuse.”
To request a calculator analysis for your population, please contact Karlynn Billings atkbillings@primrosehealthcare.com or Richard Diefenderfer at richardd@primrosehealthcare.com. Finally, to view the Milliman study referenced above, please visit the Primrose Healthcare website athttps://www.primrosehealthcare.com/press/milliman.
While many payers may concentrate on managing anti-viral medication treatment costs, they may not closely focus on the underlying medical cost drivers within the population. The calculator analysis provides payers with a complete picture of typical non-antiviral treatment costs, including prevalence and key cost drivers such as stage of liver disease (i.e. chronic HCV, cirrhosis, etc.), other non-antiviral medication treatment costs and medical costs.
“Calculator analyses run to date clearly show that new medication treatments are not the only reason for high costs among the HCV populations,” said Henri Cournand, CEO of Primrose Healthcare. “Payers focused on medication costs alone are missing out on a valuable opportunity to improve health and reduce per-member-per-month costs related to managing these patients. This really comes to light when you consider that the average annual incremental non-antiviral drug medical costs for an individual with HCV are $21,888—four times higher than those without HCV.”
These costs are driven by the HCV population’s unique characteristics as outlined in the Milliman study. Patients within a commercial population with HCV have:
3-4 times more emergency room (ER) visits
3-4 times greater rates of mental health disorder
5-6 times greater inpatient admission rates
9-10 times greater rate of alcohol dependence and/or alcoholic liver disease
20 times higher rates of drug dependence/abuse
Additionally, the calculator also estimates the “future” costs associated with HCV and liver care. Thanks to advancements in anti-viral medications, many individuals are cured of the virus. However, many of those same patients will suffer from liver damage and require care long after their cure. The calculator breaks down the associated costs based on the disease progression to give payers a clearer picture of their overall healthcare expenses.
Ultimately, the calculator tool—an industry first— is designed to help payers evaluate their existing hepatitis C management program and make decisions to modify or enhance it. To that end, the calculator can model payer-specific results, which can be used to inform their approach to managing individuals with hepatitis C and the associated costs.
According to Cournand, “Payers must develop a consistent approach for HCV patients that should include not just anti-viral medications but also intensive outreach to address comorbidities, poor treatment adherence, behavioral health issues and substance abuse.”
To request a calculator analysis for your population, please contact Karlynn Billings atkbillings@primrosehealthcare.com or Richard Diefenderfer at richardd@primrosehealthcare.com. Finally, to view the Milliman study referenced above, please visit the Primrose Healthcare website athttps://www.primrosehealthcare.com/press/milliman.
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