title: The impact on hospital resource utilisation of treatment of hepatic encephalopathy with rifaximin-α.
abstract: Rifaximin-α reduces the risk of recurrence of overt hepatic encephalopathy. However, there remain concerns regarding the financial cost of the drug. We aimed to study the impact of treatment with rifaximin-α on healthcare resource utilisation using data from seven UK liver treatment centres.
  
  
  
  All seven centres agreed a standardised data set and data characterising clinical, demographic and emergency hospital admissions were collected retrospectively for the time periods 3, 6 and 12 months before and following initiation of rifaximin-α. Admission rates and hospital length of stay before and during therapy were compared. Costs of admissions and drug acquisition were estimated using published sources. Multivariate analyses were carried out to assess the relative impact of various factors on hospital length of stay.
  
  
  
  Data were available from 326 patients. Following the commencement of rifaximin, the total hospital length of stay reduced by an estimated 31-53%, equating to a reduction in inpatient costs of between £4858 and £6607 per year. Taking into account drug costs of £3379 for 1-year treatment with rifaximin-α, there was an estimated annual mean saving of £1480-£3228 per patient.
  
  
  
  Initiation of treatment with rifaximin-α was associated with a marked reduction in the number of hospital admissions and hospital length of stay. These data suggest that treatment of patients with rifaximin-α for hepatic encephalopathy was generally cost saving.
authors.affiliation: Liver Unit, Freeman Hospital, Newcastle upon Tyne, UK.|Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: James G
authors.initials: JG
authors.lastname: Orr
authors.affiliation: Cochrane Institute, School of Medicine, Cardiff University, Cardiff, UK.|Pharmatelligence, Cardiff, UK.
authors.forename: Craig J
authors.initials: CJ
authors.lastname: Currie
authors.affiliation: Pharmatelligence, Cardiff, UK.
authors.forename: Ellen
authors.initials: E
authors.lastname: Berni
authors.affiliation: Gastroenterology, Royal Bolton Hospital, Bolton, UK.
authors.forename: Anurag
authors.initials: A
authors.lastname: Goel
authors.affiliation: Gastroenterology, Royal Bolton Hospital, Bolton, UK.
authors.forename: Kieran J
authors.initials: KJ
authors.lastname: Moriarty
authors.affiliation: Liver Unit, Bristol Royal Infirmary, Bristol, UK.
authors.forename: Ashish
authors.initials: A
authors.lastname: Sinha
authors.affiliation: Liver Unit, Bristol Royal Infirmary, Bristol, UK.
authors.forename: Fiona
authors.initials: F
authors.lastname: Gordon
authors.affiliation: Gastroenterology, Ninewells Hospital, Dundee, UK.
authors.forename: Anne
authors.initials: A
authors.lastname: Dethier
authors.affiliation: Gastroenterology, Ninewells Hospital, Dundee, UK.
authors.forename: John F
authors.initials: JF
authors.lastname: Dillon
authors.affiliation: Gastroenterology, The Royal Liverpool University Hospital, Liverpool, UK.
authors.forename: Katie
authors.initials: K
authors.lastname: Clark
authors.affiliation: Gastroenterology, The Royal Liverpool University Hospital, Liverpool, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Richardson
authors.affiliation: Institute of Liver Studies and Transplantation, King's College London School of Medicine, King's College Hospital, London, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Middleton
authors.affiliation: Institute of Liver Studies and Transplantation, King's College London School of Medicine, King's College Hospital, London, UK.
authors.forename: Vishal
authors.initials: V
authors.lastname: Patel
authors.affiliation: Institute of Liver Studies and Transplantation, King's College London School of Medicine, King's College Hospital, London, UK.
authors.forename: Debbie
authors.initials: D
authors.lastname: Shawcross
authors.affiliation: Gastroenterology and Hepatology, Queen Alexandra Hospital, Portsmouth, UK.
authors.forename: Helen
authors.initials: H
authors.lastname: Preedy
authors.affiliation: Gastroenterology and Hepatology, Queen Alexandra Hospital, Portsmouth, UK.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Aspinall
authors.affiliation: Liver Unit, Freeman Hospital, Newcastle upon Tyne, UK.|Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Hudson
mesh_terms: D000368:Aged; D017046:Cost Savings; D016527:Drug Costs; D005260:Female; D017048:Health Care Costs; D006295:Health Resources / Q000706:statistics & numerical data; D006501:Hepatic Encephalopathy / Q000188:drug therapy*; D006761:Hospitals; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012008:Recurrence; D012044:Regression Analysis; D012189:Retrospective Studies; D012294:Rifamycins / Q000627:therapeutic use*; D000078262:Rifaximin; D006113:United Kingdom
chemical_list: D012294:Rifamycins; D000078262:Rifaximin
keywords: cirrhosis; health economics; hepatic encephalopathy; rifaximin-α