TY - JOUR
T1 - Changing demographics among populations prescribed HCV treatment, 2013-2017
AU - Tsai, Naoky
AU - Bacon, Bruce
AU - Curry, Michael
AU - Flamm, Steven L.
AU - Milligan, Scott
AU - Wick, Nicole
AU - Younossi, Zobair
AU - Afdhal, Nezam
N1 - Funding Information:
Source of Funding: Funding for this study was provided by Gilead Sciences, Inc.
Funding Information:
Author Disclosures: Dr Tsai consults for and has received grants and honoraria from Gilead, AbbVie, Merck, and Bristol-Myers Squibb; he has received lecture fees from Gilead and AbbVie. Dr Curry consults for Trio Health Analytics and Gilead. Dr Bacon is the chair of the American Association for the Study of Liver Diseases Foundation Board and has received honoraria/lecture fees for speaking for AbbVie and Gilead. Dr Flamm consults for and has received lecture fees from Gilead, AbbVie, and Merck; he has received grants from Gilead and AbbVie. Dr Milligan and Ms Wick are employed by Trio Health Analytics and have received research support from Gilead, Merck, and AbbVie. Dr Younossi has received grants from Gilead, Intercept, Bristol-Myers Squibb, GlaxoSmithKline, and Novo Nordisk. Dr Afdhal is a paid consultant/advisory board member for Gilead, Echosens, Ligand, Shionogi, and Trio Health; owns stock in SpringBank and Allurion and has stock options in SpringBank; receives royalty income from UpToDate; and is on the board of directors for the nonprofit Liver Institute for Education and Research.
Publisher Copyright:
© 2019 College of Family Physicians of Canada. All rights reserved.
PY - 2019/7
Y1 - 2019/7
N2 - OBJECTIVES: We analyzed the demographics and disease characteristics of patients prescribed treatment for chronic hepatitis C virus (HCV) infection from 2013 through 2017, a time frame that encompasses the expansion of available direct-acting antiviral inhibitors. STUDY DESIGN: Retrospective analysis. METHODS: Using a proprietary disease-management program, data for 19,944 patients receiving HCV treatment were collected from providers and specialty pharmacies. Six-month time periods accounting for introductions of novel treatments were established as follows: December 2013 to May 2014 (n = 1438), simeprevir and sofosbuvir; October 2014 to March 2015 (n = 2242), ledipasvir/sofosbuvir and ombitasvir/paritaprevir/ritonavir plus dasabuvir; October 2015 to March 2016 (n = 5514), daclatasvir; July 2016 to December 2016 (n = 5562), elbasvir/grazoprevir and sofosbuvir/velpatasvir; and July 2017 to December 2017 (n = 5188), sofosbuvir/velpatasvir/voxilaprevir and glecaprevir/pibrentasvir. Changes over time were evaluated for statistical significance. RESULTS: In the 2013-2014 time period, 44% of patients receiving prescriptions for HCV treatment were treatmentexperienced and 45% had cirrhosis. By 2017, only 14% were treatment-experienced (P <.001) and 21% had cirrhosis (P <.001). The percentage of patients with HCV genotype 1 increased from 69% to 87% from 2013-2014 to 2014-2015 (P <.001) but subsequently decreased to 74% in 2017 (P <.001). The percentage of patients receiving HCV prescriptions in an academic setting declined from 61% in 2013-2014 to 13% in 2017 (P <.001). CONCLUSIONS: In the United States, since the introduction of interferon-free HCV regimens, the patient population prescribed treatment has changed, becoming predominantly treatment-naïve, without cirrhosis, and treated in nonacademic centers.
AB - OBJECTIVES: We analyzed the demographics and disease characteristics of patients prescribed treatment for chronic hepatitis C virus (HCV) infection from 2013 through 2017, a time frame that encompasses the expansion of available direct-acting antiviral inhibitors. STUDY DESIGN: Retrospective analysis. METHODS: Using a proprietary disease-management program, data for 19,944 patients receiving HCV treatment were collected from providers and specialty pharmacies. Six-month time periods accounting for introductions of novel treatments were established as follows: December 2013 to May 2014 (n = 1438), simeprevir and sofosbuvir; October 2014 to March 2015 (n = 2242), ledipasvir/sofosbuvir and ombitasvir/paritaprevir/ritonavir plus dasabuvir; October 2015 to March 2016 (n = 5514), daclatasvir; July 2016 to December 2016 (n = 5562), elbasvir/grazoprevir and sofosbuvir/velpatasvir; and July 2017 to December 2017 (n = 5188), sofosbuvir/velpatasvir/voxilaprevir and glecaprevir/pibrentasvir. Changes over time were evaluated for statistical significance. RESULTS: In the 2013-2014 time period, 44% of patients receiving prescriptions for HCV treatment were treatmentexperienced and 45% had cirrhosis. By 2017, only 14% were treatment-experienced (P <.001) and 21% had cirrhosis (P <.001). The percentage of patients with HCV genotype 1 increased from 69% to 87% from 2013-2014 to 2014-2015 (P <.001) but subsequently decreased to 74% in 2017 (P <.001). The percentage of patients receiving HCV prescriptions in an academic setting declined from 61% in 2013-2014 to 13% in 2017 (P <.001). CONCLUSIONS: In the United States, since the introduction of interferon-free HCV regimens, the patient population prescribed treatment has changed, becoming predominantly treatment-naïve, without cirrhosis, and treated in nonacademic centers.
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M3 - Article
C2 - 31318504
AN - SCOPUS:85070057824
SN - 1088-0224
VL - 25
SP - 319
EP - 323
JO - American Journal of Managed Care
JF - American Journal of Managed Care
IS - 7
ER -
