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Hepatitis Log

At the Crossroads: Hepatitis C Infection in Maine

A Comprehensive Statewide Needs Assessment
The Maine Hepatitis C Infection
Needs Assessment Steering Committee

February 2001

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Economic Impact and Cost of Care for Hepatitis C Infection

The 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 hepatitis C.

To 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

All 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.

Currently, 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. 

A 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.

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