Evaluating the Effect of Standard of Care Treatment on Burden of Chronic Hepatitis B: A Retrospective Analysis of the United States Veterans Population

Autor: Janvi Sah, Jamie Colasurdo, Eva G. Katz, U. Sbarigia, Furaha Kariburyo, Lin Xie, Shirley V Sylvester
Rok vydání: 2020
Předmět:
Adult
Male
030213 general clinical medicine
medicine.medical_specialty
Standard of care
Adolescent
Population
HIV Infections
Pharmacy
Economic burden
Antiviral Agents
Chronic hepatitis B
Medication Adherence
Persistence (computer science)
Persistence
Young Adult
03 medical and health sciences
Hepatitis B
Chronic
0302 clinical medicine
Chronic hepatitis
Internal medicine
Health care
Retrospective analysis
Humans
Medicine
Pharmacology (medical)
Medical prescription
education
Aged
Retrospective Studies
Original Research
Infectious disease
education.field_of_study
business.industry
Standard of Care
General Medicine
Middle Aged
Patient Acceptance of Health Care
United States
Nucleos(t)ide analogues
United States Department of Veterans Affairs
030220 oncology & carcinogenesis
Female
Health Expenditures
business
Zdroj: Advances in Therapy
ISSN: 1865-8652
0741-238X
Popis: Introduction This study aimed to characterize chronic hepatitis B (CHB)-infected patients and estimate the association between nucleos(t)ide analogue (NA) persistence and economic outcomes using data from the Veterans Health Administration (VHA) database. Methods Patients (at least 18 years of age) with two or more claims for CHB and at least one pharmacy claim for NA were identified using VHA data from 1 April 2013 to 31 March 2018. The index date was the first NA prescription fill date during 1 October 2014 to 31 March 2017. Persistence and non-persistence to NA treatment were assessed during the first 2 years post index date. Non-persistence was defined as at least one failure to refill medication within 30 days from the run-out date. Generalized linear models were used to compare health care utilization and costs between persistent and non-persistent patients. Results Among patients treated with NAs (N = 2368), 1428 (60%) were CHB mono-infected and 748 (32%) were HIV co-infected. Total costs per patient per year (PPPY) were $39,240, $29,957, and $55,220 PPPY for NA-treated, mono-infected, and HIV co-infected patients, respectively. An inception cohort of 564 patients (24%), without a NA prescription in the 6 months pre-index period and at least 2 years of follow-up, was created. Persistence among the inception cohort was 29% for first year and 14% for first 2 years. After adjustment for baseline differences, persistent patients had lower cumulative overall health care costs compared to non-persistent patients, with a net cost saving of $851 (p > 0.05) in the first 2 years. Conclusion CHB is associated with considerable economic burden. We observed suboptimal persistence to NAs which decreased over time. Short-term savings could be generated for CHB-infected patients when they remain persistent to NAs. Electronic supplementary material The online version of this article (10.1007/s12325-020-01240-1) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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