Abstract
Background: New therapies for hepatitis C [HCV] are under development which will likely augment the standard treatment regimen of pegylated interferon-alpha plus ribavirin [P/R] to improve patient outcomes and possibly shorten P/R duration. However, few studies have evaluated the economic implications associated with P/R treatment duration in real world practice. Objective: To estimate the impact of P/R treatment duration on health care costs in real-world clinical practice. Methods: Paid claims data for 2003-2010 were retrieved from a large U.S. health insurance company and 148, 176 HCV patients were identified. Only 7,840 HCV patients received P/R treatment [5.3%]. Patients were then screened for a minimum of 6 months of data prior and 24 months of data after the start of P/R drug therapy. Patients with a pre-treatment diagnosis for HIV, hepatitis B, cirrhosis, liver cancer or a liver transplantation were also excluded. The impact of treatment duration on cost and adverse event risk was estimated by comparing patients with 24-48 weeks and 48+ weeks of therapy to patients with 0.05]. First year drug costs for patients with 48+ weeks of treatment were +$27,116 [p 48 weeks were not sufficient to offset drug costs, these results were reversed in year 2. This suggests that a full course of P/R therapy may reduce total cost over time. More research is needed to determine if year 2 savings associated with compliance with drug therapy continues on beyond year 2.
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