Impact of adverse events on costs and quality of life in protease inhibitor-based combination therapy for hepatitis C.
Protease inhibitor with pegylated interferon and ribavirin therapy (PI-PR) increases hepatitis C virus treatment efficacy versus standard of care pegylated interferon and ribavarin therapy [PR]. The adverse event (AE) impact of PI-PR remains under-reported. The authors estimated the AE impact on costs, treatment discontinuation and health-related quality of life (HRQoL) in PI-PR- and PR-treated patients through literature review and cost analysis. HRQoL and safety data were synthesized by instrument, AE and discontinuation rate. AE-related treatment costs were estimated with trial-based AE rates and literature-based protocols, resource utilization and standard costs. No PI-PR study reported HRQoL outcomes. Five PR studies reported that anemia, depression, fatigue and/or influenza-like symptoms negatively affected HRQoL. Decreased HRQoL predicted treatment discontinuation in two PR studies. PI-PR and PR had comparable AE-related treatment discontinuation rates (~12%). Weighted AE-related treatment costs were US$2042, $1835 and $1076 in boceprevir-based PI-PR, PR and telaprevir-based PI-PR, respectively. AE-related burden may increase with PI-PR. Future studies should incorporate AE-related economic and HRQoL outcomes to comprehensively assess costs/benefits.
Pharmerit North America LLC, Bethesda, MD, USA. cgao@pharmerit.com
Xin
X
Gao
Jennifer M
JM
Stephens
John A
JA
Carter
Seema
S
Haider
Vinod K
VK
Rustgi
D000998:Antiviral Agents / Q000009:adverse effects* / Q000191:economics / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D017048:Health Care Costs; D006526:Hepatitis C / Q000188:drug therapy*; D006801:Humans; D007372:Interferons / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D011480:Protease Inhibitors / Q000009:adverse effects* / Q000191:economics / Q000627:therapeutic use; D011788:Quality of Life; D012254:Ribavirin / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use
D000998:Antiviral Agents; D011480:Protease Inhibitors; D012254:Ribavirin; D007372:Interferons