2016-11-01
Real-world medical costs of antiviral therapy among patients with chronic HCV infection and advanced hepatic fibrosis
Publication
Publication
Journal of Gastroenterology and Hepatology , Volume 31 - Issue 11 p. 1851- 1859
Background and Aims: Very potent direct acting antivirals for the treatment of chronic
hepatitis C virus infection were recently introduced into daily clinical practice. Currently,
treatment uptake is hampered by their high costs, eliciting prioritization of treatment. We
aimed to evaluate the direct medical costs during interferon (IFN)-based antiviral treatment
and the costs per sustained virological response (SVR) among patients with advanced hepatic
fibrosis.
Methods: This retrospective cohort study included all consecutive patients with chronic
hepatitis C virus infection and biopsy-proven bridging fibrosis or cirrhosis (Ishak 4–6)
treated with IFN-based regimens in five hepatology units of tertiary care centers in Europe
and Canada. Direct medical costs, expressed in 2013 Euros, during therapy were assessed.
The components of care were quantified by three distinct categories: treatment, safety/
monitoring, and complications. Cost per SVR was calculated by dividing the mean cost
by the SVR rate.
Results: In total, 672 interferon-based treatments administered to 455 patients were included.
Total medical costs per patient were averaged to €14 559 (95% confidence interval
[CI], €13 323–€15 836). The mean cost per SVR was €38 514 (95% CI, €35 244–€41 892).
The costs per SVR were €26 105 (95% CI, €23 068–€29 296) for patients with a normal
platelet count and €50 907 (95% CI, €44 151–€59 612) for patients with thrombocytopenia,
with the costs per SVR of €74 961 (95% CI, €55 463–€103 541) among those patients
with a platelet count below 100 * 109/L.
Conclusions: Because of the lower SVR rates, the cost per SVR of IFN-based treatment
increased when patients with more advanced liver disease were treated. Additional costs
of IFN-free therapy could be limited among these patients.
Additional Metadata | |
---|---|
, , , , , | |
doi.org/10.1111/jgh.13373, hdl.handle.net/1765/98464 | |
Journal of Gastroenterology and Hepatology | |
Organisation | Erasmus School of Health Policy & Management (ESHPM) |
Maan, R., Zaim, R., van der Meer, A., Feld, J. J., Wedemeyer, H., Dufour, J.-F., … Uyl-de Groot, C. (2016). Real-world medical costs of antiviral therapy among patients with chronic HCV infection and advanced hepatic fibrosis. Journal of Gastroenterology and Hepatology, 31(11), 1851–1859. doi:10.1111/jgh.13373 |