Incidence and cost of treatment-emergent comorbid events in insured patients with chronic hepatitis C virus infection: a retrospective cohort study

BMC Health Services Research

Gilbert L’Italien³  Michael S Broder²  Eunice Chang²  Sandhya Sapra¹ 

[1]Bristol-Myers Squibb, 1146 Lawrenceville Road, Lawrenceville, NJ, USA

[2]Partnership for Health Analytic Research, LLC, 280 S. Beverly Drive, Suite 404, Beverly Hills, CA, USA

[3]Yale University School of Medicine, 333 Cedar Street, New Haven, CT, USA

关键词: Ribavirin;    Pegylated interferon alpha;    Retrospective study;    Insurance claims;   

Others  :  1126169
DOI  :  10.1186/1472-6963-14-429

 received in 2014-03-14, accepted in 2014-09-11,  发布年份 2014

【 摘 要 】

Background

Treatment-emergent comorbid events (TECs) are common In patients initiating treatment with pegylated interferon alpha (PEG-IFN-alfa) and ribavirin for chronic hepatitis C virus (HCV) infection. The purpose of this study was to estimate the incidence and incremental cost of these events.

Methods

In a retrospective cohort analysis of healthcare claims, we studied patients with HCV who were newly treated with PEG-IFN-alfa/ribavirin between 2006 and 2008. TECs were defined by new medical/pharmacy claims for predefined conditions in the 12 months after treatment initiation. The net incremental cost of the TECs was the difference between baseline and follow-up costs for these comorbidities and their treatment, excluding PEG-IFN-alfa/ribavirin costs.

Results

Of 3,795 newly treated patients, 1,269 (mean age 50.2, 36.2% female) met the selection criteria. New TECs were common, with 61.6% of patients having ≥1 event. Anemia was identified in 29.2% of patients, fatigue in 16.4%, depression in 11.5%, and neutropenia in 11.0%. The mean incremental cost for the predefined TEC in the postindex period was $6,377 ($2,782 for medical and $3,595 for pharmacy claims).

Conclusions

In an insured US cohort with chronic HCV infection, TECs with PEG-IFN-alfa/ribavirin were common and increased costs by approximately $6,000 per treated patient. This estimate may be conservative because it excludes indirect costs. Costs might increase with new regimens that include a protease inhibitor because additional TECs may be expected. Better-tolerated therapies that reduce the financial burden on the healthcare system and improve patient experience are needed.

【 授权许可】

   
2014 Sapra et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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