Treatment persistence in and cost of therapy for patients with chronic hepatitis C: Peginterferon alfa-2a plus ribavirin versus peginterferon alfa-2b plus ribavirin.
OBJECTIVE
Treatment persistence and cost of therapy for patients with chronic hepatitis C (CHC) treated with peginterferon alfa-2a plus ribavirin and peginterferon alfa-2b plus ribavirin were evaluated.


METHODS
This retrospective database analysis used eligibility, pharmacy, and medical claims data from a large U.S. health plan for patients with CHC treated with peginterferon alfa-2a plus ribavirin and peginterferon alfa-2b plus ribavirin from January 2002 through June 2006. For the purposes of this analysis, the study population included all hepatitis C virus (HCV) genotypes. Comparable groups for assessment of outcomes were constructed using propensity score matching to reduce the effect of known sources of bias. Outcome variables included treatment persistence and annualized overall and HCV-attributable health care costs.


RESULTS
A total of 1783 matched pairs were analyzed. Compared with patients receiving peginterferon alfa-2a plus ribavirin, patients receiving peginterferon alfa-2b plus ribavirin were 18% less likely to be persistent with therapy at week 48 (p = 0.013). During the first six months of follow-up, mean all-cause costs (p = 0.0368) and HCV-attributable costs (p < 0.0001) were significantly lower for peginterferon alfa-2a plus ribavirin than for peginterferon alfa-2b plus ribavirin. Mean annualized all-cause costs (p = 0.0060) and HCV-attributable costs (p = 0.0167) over the entire follow-up period were significantly lower for patients treated with peginterferon alfa-2a plus ribavirin versus peginterferon alfa-2b plus ribavirin.


CONCLUSIONS
Analysis of information from a health care claims database suggests that treating CHC with peginterferon alfa-2a plus ribavirin may improve treatment persistence and help reduce the health care costs imposed by CHC compared with treatment with peginterferon alfa-2b plus ribavirin.
Brixner
Diana I
DI
Department of Pharmacotherapy, College of Pharmacy, University of Utah, 30 South 2000 East, Salt Lake City, UT 84112, USA. diana.brixner@utah.edu
Ye
Xin
X
Chu
Teng-Chiao
TC
Blumentals
William A
WA
Hassanein
Tarek I
TI
D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000191:economics* / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000191:economics*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000191:economics* / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010592:Pharmaceutic Aids; D011092:Polyethylene Glycols / Q000737:chemistry / Q000191:economics* / Q000627:therapeutic use*; D011994:Recombinant Proteins; D012189:Retrospective Studies; D016896:Treatment Outcome
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D010592:Pharmaceutic Aids; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; C417083:peginterferon alfa-2b; C100416:peginterferon alfa-2a