Use of healthcare resources and drug expenditure before and after treatment of chronic hepatitis C with direct antiviral agents

Mercedes Vergara Gómez, Mireia Miquel Planas, Emili Vela, Montserrat Cleries, Caridad Pontes, Maria Alba Prat Casanovas, Montse Rué

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    The aim of this study was to analyse the impact of treating chronic hepatitis C (CHC) with direct acting agents (DAA) on the use of healthcare resources. We included all patients treated with DAA for CHC from January 2015 to December 2017 in Catalonia whose medical records from 12 months before to 24 months after treatment were available. Data was obtained from the Catalan Health Surveillance System. 12,199 patients in Catalonia were treated with DAA for CHC. Of these, 11.3% had no-minimal fibrosis (F0-F1), 24.0% had moderate fibrosis (F2), 50.3% had significant fibrosis or cirrhosis (F3-F4) and 14.4% had decompensated cirrhosis. Use of healthcare resources decreased from the pre-treatment period to the post-treatment period for: hospital admissions due to complications of cirrhosis, from 0.19 to 0.12 per month per 100 patients (RR 0.57; 95% CI 0.47-0.68); length of hospital stay, from 12.9 to 12.2 days (RR 0.93; 95% CI 0.91-0.94); outpatient visits, from 65.0 to 49.2 (RR 0.75; 95% CI 0.74-0.75); and number of medication containers per patient per month, from 13.9 to 12.5 (RR 0.837; 95% CI 0.835-0.838). However, the number of invoices for antineoplastic treatment increased after DAA treatment, especially for patients with high morbidity or advanced fibrosis stage. In conclusion, a decrease in health resource use was seen in CHC patients treated with DAA, as measured by length of hospital stay, number of admissions due to cirrhosis complications, outpatient visits and overall drug invoicing. However, use of antineoplastic drugs increased significantly, especially in patients with cirrhosis and high morbidity.

    Original languageEnglish
    Pages (from-to)728-738
    Number of pages11
    JournalJournal of Viral Hepatitis
    Volume28
    Issue number5
    Early online date8 Feb 2021
    DOIs
    Publication statusPublished - 11 Mar 2021

    Keywords

    • chronic hepatitis C
    • cirrhosis
    • direct antiviral agents
    • drug use
    • healthcare resources
    • Antiviral Agents/therapeutic use
    • Humans
    • Liver Cirrhosis/drug therapy
    • Hepatitis C, Chronic/drug therapy
    • Pharmaceutical Preparations
    • Health Expenditures

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