OBJECTIVES: Rifaximin-α (RFX) is an antibiotic therapy that can reduce the occurrence and severity of episodes of hepatic encephalopathy (HE) in patients with hepatic failure. The IMPRESS II study collected healthcare resource use (HRU) data from HE patients treated with RFX across nine United Kingdom National Health Service hospitals. In this study, we applied costs to the resource utilisation reported in IMPRESS-II.

METHODS: Resource use data in the period from 1-5 years after RFX initiation was collected during the IMPRESS-II study for 138 patients. This data comprised inpatient admissions, outpatient appointments, emergency department (ED) attendances and intensive care admissions. We applied mean costs derived from a previous study to the resource utilisation observed in IMPRESS-II. These costs were derived from Healthcare Resource Groups mapped to the National Tariff 2019-20 and adjusted for inflation.

RESULTS: Total healthcare resource costs for HE patients 1-5 years post-RFX treatment initiation was primarily driven by inpatient admissions. For all-cause contacts, costs were £1,085,305 for inpatient admissions, £153,009 for outpatient appointments, £35,997 for ED visits, and £25,602 for ICU admissions. Respective costs for liver-related contacts were £849,972, £91,353, £19,508, and £11,379. The median cost per patient year for liver-related (all-cause) resource use in the 1-2 years post-RFX initiation was £308.70 (£386.50) for outpatient visits and £0 (£0) for ED visits, inpatient admissions, and ICU admissions. These costs remained stable in the 2-5 years post-initiation, with £279.17 (£400.40) for outpatient visits and £0 (£0) for ED visits, inpatient admissions, and ICU admissions.

CONCLUSIONS: In conjunction with previous studies showing significant reductions in the number and duration of hospital admissions for HE patients treated with RFX, these results support the argument that RFX could help mitigate some of the more substantial costs associated with the management of HE and provide a long-term economic benefit.