Trends in the healthcare burden of hepatitis C after the introduction of direct-acting antivirals in Japan, 2013-2022: A national claims database study in Japan.

[OBJECTIVES] To describe trends in the incidences of chronic hepatitis C, hepatocellular carcinoma (HCC), and related healthcare burden after the introduction of interferon-free direct-acting antivirals (DAAs).

[METHODS] This repeated cross-sectional study (time trend analysis) examined chronic hepatitis C and related healthcare, including HCC, using national claims data covering >98% of healthcare services in Japan between fiscal years 2013 and 2022.

[RESULTS] During the study period, 357,877 patients were treated with DAAs. The prevalence of individuals receiving care for chronic hepatitis C decreased by 40% (95% confidence interval [CI]: 40-40%), from 0.54% in 2013 to 0.33% in 2022. Among individuals with HIV, the reduction was smaller, at 16% (95% CI: 10-20%), with a prevalence of 3.82% in 2022. The annual incidence of newly diagnosed HCC decreased by 69% (95% CI: 68-70%), accompanied by a reduction in HCC treatments. Annual healthcare costs for individuals with chronic hepatitis C peaked in 2015 and decreased to 65% of 2013 levels by 2022.

[CONCLUSION] During the 10-y DAA era, the healthcare burden of hepatitis C declined substantially in Japan. Enhanced efforts in prevention, screening, and treatment are critical for the eradication of hepatitis C, particularly among high-risk populations, such as individuals with HIV.