Interferon-based therapies for hepatitis C: Utilization, costs, and outcomes

Yvonne C. Jonk, Titilope Adeniyi, Astrid Knott, Eric W. Dieperink, Samuel B. Ho

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Background: Veterans using the Veterans Health Administration's (VA's) services have a higher incidence of chronic hepatitis C virus (HCV) infection than the general population. Objectives: To examine treatment patterns, direct costs associated with interferon-based HCV therapy, and sustained virologic response (SVR) rates for genotypes 1 and 2. Study Design: Retrospective review of utilization, cost, and outcome data for a cohort of 99 consecutive patients diagnosed with HCV receiving antiviral therapy beginning in January 2000 at a midwestern VA Medical Center. Methods: Outpatient utilization and direct costs of clinical encounters and medications spanning calendar years 1997 to 2004 were extracted from VA administrative databases for 3 therapy combinations: interferon and ribavirin (IR); interferon, pegylated interferon, and ribavirin; and pegylated interferon and ribavirin (PR). Final costs were adjusted to 2010 prices. Identifying patients' earliest diagnostic dates ensured analyses of treatmentnaïve patients. Results: Clinic visits and medications accounted for 20% and 80% of treatment costs respectively, regardless of genotype. Although genotype 1 patients' treatment length and costs were substantially higher than those of non-genotype 1 patients, SVR rates were lower (31%) than those in non-genotype 1 patients (57%). Cost per SVR for genotype 1 patients ranged from $54,768 (IR) to $70,364 (PR). The overall cost per SVR for non-genotype 1 patients was $25,152. Conclusions: Antiviral medications accounted for the majority of treatment costs. Cost per SVR was sensitive to genotype, effi cacy, and treatment duration. Utilization, costs, and outcomes associated with interferon-based treatments serve as important baseline data for future comparative cost-effectiveness analyses.

Original languageEnglish (US)
Pages (from-to)25-33
Number of pages9
JournalAmerican Journal of Pharmacy Benefits
Volume5
Issue number1
StatePublished - Feb 20 2013

ASJC Scopus subject areas

  • Business and International Management
  • Pharmacology, Toxicology and Pharmaceutics (miscellaneous)
  • Decision Sciences (miscellaneous)

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