DIFFERENCE IN HEALTHCARE UTILIZATION IN EUROPE BETWEEN TREATMENT-NAÏVE PATIENTS WITH CHRONIC HEPATITIS C AND PATIENTS WHO FAILED PRIOR THERAPY
Author(s)
Huabin Zhang, MD, MPH, Director1, Siva Narayanan, MS, MHS, Vice President and Practice Leader21Johnson & Johnson Pharmaceutical Services, LLC, Raritan, NJ, USA; 2 TNS Healthcare, New York, NY, USA
OBJECTIVES: - /* Font Definitions */ @font-face {; panose-1:2 1 6 0 3 1 1 1 1 1; mso-font-alt:"Arial Unicode MS"; mso-font-charset:134; mso-generic-; mso-font-format:other; mso-font-pitch:variable; mso-font-signature:1 135135232 16 0 262144 0;} @font-face {;\@SimSun"; panose-1:0 0 0 0 0 0 0 0 0 0; mso-font-charset:134; mso-generic-; mso-font-format:other; mso-font-pitch:variable; mso-font-signature:1 135135232 16 0 262144 0;} /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-parent:""; margin:0cm; margin-bottom:.0001pt; mso-pagination:widow-orphan; ;"; mso-fareast-; mso-ansi-language:EN-US; mso-fareast-language:EN-US;} @page Section1 {size:612.0pt 792.0pt; margin:72.0pt 90.0pt 72.0pt 90.0pt; mso-header-margin:36.0pt; mso-footer-margin:36.0pt; mso-paper-source:0;} div.Section1 {page:Section1;} --> /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; ""; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;}This study aims to assess if hepatitis C patients who had previously failed to achieve sustained virologic response (SVR) following any hepatitis C treatment demonstrate different patterns of healthcare utilization versus treatment-naïve patients after peginterferon plus ribavirin (PR) therapy in the European Union. METHODS: st1\:*{behavior:url(#ieooui) } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; ""; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;}A retrospective chart review of hepatitis C patients who received PR was conducted in the UK, Germany, France, Italy, and Spain. Descriptive analyses reported standardized annual rates of hospitalizations, emergency/accident visits (EA), family physician/general practitioner visits (GP), specialist visits (SP), and having ≥5 clinical tests (TESTS). Logistic regression models were applied to assess TF status impact on aforementioned outcomes. RESULTS: /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; ""; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;}165 physicians collected data for 615 patients (baseline data: mean age 43.7 years, 33% female, 90% Caucasian, 85% genotype-1, 26% viral load >1,000,000 IU/mL, 25% with prior treatment failure [TF]). PR was administered for a median of 9.1 months (interquartile range: 5.3–11.9); median post-treatment follow-up was 6.0 months (interquartile range: 2.0–10.0). Fewer TF patients achieved SVR than treatment-naïve patients (43.3% versus 58.3%). Compared with treatment-naïve patients, TF patients had significantly more annual hospitalizations (1.7 versus 0.3), EA (0.7 versus 0.2), GP (4.3 versus 2.0), SP (4.1 versus 2.3), and TESTS (75% versus 85%) (p<0.05 for all). When controlling for confounding factors (age, weight, gender, genotype, time between diagnosis and treatment initiation, alcohol intake, past intravenous drug use, pre-treatment liver biopsy, steatosis, pre-viral RNA, and SVR status), TF remained an independent risk factor for significant risk of hospitalization (OR=4.33, 95% CI=2.38–7.87), EA (OR=2.63, 95% CI=1.49–4.76), GP (OR=3.45, 95% CI=2.04–5.56), SP (OR=2.86, 95% CI=1.72–4.76) and TESTS (OR=2.04, 95% CI=1.14–3.70). Similar results were found in the genotype-1 patients. CONCLUSIONS: /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; ""; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;}Hepatitis C patients who failed prior treatment demonstrate higher healthcare resource use than treatment-naïve patients after PR therapy, regardless of SVR status.
Conference/Value in Health Info
2008-11, ISPOR Europe 2008, Athens, Greece
Value in Health, Vol. 11, No. 6 (November 2008)
Code
PIN43
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Infectious Disease (non-vaccine), Respiratory-Related Disorders