Maan, Raoel; Zaim, Remziye; van der Meer, Adriaan J; Feld, Jordan J; Wedemeyer, Heiner; Dufour, Jean-François; Lammert, Frank; Manns, Michael P; Zeuzem, Stefan; Hansen, Bettina E; Janssen, Harry LA; Veldt, Bart J; de Knegt, Robert J; Uyl-de Groot, Carin A (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), pp. 1851-1859. Wiley-Blackwell Publishing Asia 10.1111/jgh.13373
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Real-world medical costs of antiviral therapy among patientswith chronic HCV infection and advanced hepati c fibrosis.pdf - Published Version Restricted to registered users only Available under License Publisher holds Copyright. Download (272kB) |
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 * 10(9) /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.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Hepatology 04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Hepatologie 04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Hepatologie |
UniBE Contributor: |
Dufour, Jean-François |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1440-1746 |
Publisher: |
Wiley-Blackwell Publishing Asia |
Language: |
English |
Submitter: |
Lilian Karin Smith-Wirth |
Date Deposited: |
05 Apr 2017 12:15 |
Last Modified: |
05 Dec 2022 15:01 |
Publisher DOI: |
10.1111/jgh.13373 |
PubMed ID: |
26990109 |
Uncontrolled Keywords: |
antiviral therapy; chronic HCV infection; cirrhosis; medical cost; thrombocytopenia |
BORIS DOI: |
10.7892/boris.93552 |
URI: |
https://boris.unibe.ch/id/eprint/93552 |
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