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At the Crossroads: Hepatitis C Infection in Maine
A Comprehensive Statewide
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Impact and Cost of Care for Hepatitis C Infection
economic impact of hepatitis C infection is already significant and is
expected to increase exponentially over the coming decades.
According to the Centers for Disease Control and Prevention, all
costs (medical and lost productivity) associated with acute and chronic
hepatitis C exceeded $600 million nationally in 1998.
Recent projections estimate that direct medical costs (not
charges) in the U.S. will range from $6.5 to $13.6 billion during the
period 2010-2019. Nationally,
social costs during this period, including lost productivity, are
projected to exceed $75 billion due to the major complications from
date in Maine, only Medicaid costs related to hepatitis C have been
quantified---and those only partially so.
Maine Medicaid costs (drug and non-drug) for individuals with
hepatitis C infection diagnoses increased substantially from a baseline
of about $2 million in 1996. In
1999, Medicaid made payments of $10.3 million for 644 hepatitis C
infected patients, an average of $16,000
per patient. In late 2000,
the projected cost for the Year 2000 was $12.8 million based on
expenditures for the first six months of the year.
Current Status of Hepatitis C Infection Prevention and Care in Maine
of the challenges particular to hepatitis C infection are further
complicated by problems common to the entire health and social services
system in Maine, particularly inadequate access to health care. To meet
these challenges, Maine requires a comprehensive, coordinated system of
prevention and care for those living with, or at risk for, hepatitis C
infection. Such a system would include five key components:
disease prevention, medical care, behavioral health, social
support and system coordination services.
no such system of care exists in Maine for those with, or at risk for,
hepatitis C infection.
There are no coordinated, sustained efforts in Maine to raise public awareness of hepatitis C infection, prevent new cases, or to encourage testing for those at risk. Organized hepatitis C counseling or testing services are extremely limited and there is a great need for coordinated educational and support services for hepatitis C patients and their loved ones. To the extent such services are provided, they are provided sporadically in individual locales by single agencies or voluntary groups of concerned consumers and professionals, at the expense of each agency or group.
few dozen clinicians, primarily gastroenterologists, provide medical
care for most hepatitis C patients in Maine.
Most primary health care providers in Maine currently lack a
system of specialty consultation support and the experience necessary to
manage hepatitis C patients. No one is assuring that a program of high
quality continuing education is available to Maine’s primary health
care, behavioral health and social service professionals.
In addition, it is likely that substantial numbers of inmates in Maine’s state prison system are infected with hepatitis C but are unaware of their high risk and are without the means to get tested, diagnosed, or treated.