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Impact of Chronic Hepatitis C (CHC) Treatment on Post Therapy Healthcare Cost: HCV Therapy Completers Had Significantly Reduced Post Therapy Healthcare Costs
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"Interferon users completing the therapy had significantly lower PPPY (Per-patient-per-year) costs all-cause compared to the discontinued therapy cohort
(adjusted cost difference: $-3,687 [-6,503], also had significantly lower PPPY CHC-related healthcare costs compared to those discontinuing: $-1,644 [-3,138]"
Reported by Jules Levin
HEP DART 2013:
Frontiers in Drug Development for Viral Hepatitis.
December 8-12, 2013 · Big Island, Hawaii, USA.
N Tandon1, L Balart2, F Laliberte3, D Pilon3, P Lefebvre3, A Prabhakar1
1Janssen Scientific Affairs, LLC, Titusville, NJ, USA; 2Tulane University Health Sciences Center, New Orleans, LA, USA; 3Groupe d'analyse, Ltee, Montreal, QC, Canada.
"The prevalence of chronic hepatitis C virus (HCV) in the United States in 2011 was estimated between 2.7 and 3.9 million, and
the total cost of HCV was estimated at $6.5 billion1,2..........The aim of this study is to evaluate the resource utilization and
healthcare cost alleviation associated with treatment of CHC.......An analysis of the OptumHealth Reporting and Insights
Database was conducted based on health insurance claims of 60 self-insured US companies and comprising 15 million lives
from January 2001 through March 2012.....A retrospective cohort design was used......Interferon users were categorized into complete and
discontinued therapy cohorts according to their adherence to therapy (i.e., no gap of 30 days or more between 2 refills)
during the first 36 weeks of treatment......Per-patient-per-year (PPPY) costs were calculated and compared
between cohorts......A total of 30,307 patients were identified with a chronic HCV diagnosis and 5,004 of them had an interferon dispensing claim......After all inclusion and exclusion criteria, 1,017 patients completed 36 to 48 weeks of therapy; 953 patients discontinuing the therapy were selected and formed the study
population.......The mean observation period was 1,395 days for the complete therapy cohort and 1,257 days for the discontinued therapy
cohort (Table 1)....... Patients from the complete therapy cohort used significantly fewer unadjusted all-cause healthcare resources compared to
patients in the discontinued therapy cohort.......In addition, interferon users who completed their therapy had
significantly fewer CHC-related hospitalizations compared to interferon users who discontinued (RR [95% CI]: 0.54
[0.42-0.68], P <0.0001) (Table 2)...... After adjustment, interferon users who completed their therapy had significantly
fewer all-cause and CHC-related hospitalizations compared to interferon users who discontinued
(Figure 1)"
"Healthcare Costs
· Interferon users completing the therapy had significantly lower
PPPY all-cause compared to the discontinued therapy cohort
(adjusted cost difference [95% CI]: $-3,687 [-6,503; -822],
P=0.008) (Table 3)
· Interferon users completing the therapy also had significantly
lower PPPY CHC-related healthcare costs compared to those
discontinuing (adjusted cost difference [95% CI]: $-1,644
[-3,138; -148], P=0.022)
· Reduction in CHC-related costs contributed to 45%
(-$1,644/-$3,687) of the overall observed reduction in adjusted
all-cause costs
· Non-CHC-related cost reduction contributed to 55%
(-$2,043/-$3,687) of the overall observed reduction
experienced in interferon completers
· Reduction in hospitalization (both CHC and non-CHC-related)
and emergency room visits led to the reduction in all-cause
healthcare costs in the complete therapy cohort, despite having
a higher frequency of CHC-related outpatient visits"
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