Characterizing treated vs untreated patients following a diagnosis of chronic hepatitis C virus

Document Type

Conference Proceeding

Publication Date

3-1-2022

Publication Title

Journal of Managed Care and Specialty Pharmacy

Abstract

BACKGROUND: Despite recent advances in the treatment of hepatitis C virus (HCV) a significant proportion of patients with chronic HCV remain untreated. OBJECTIVE: Estimate the proportion of patients treated, the initial regimen received, examine the time from initial diagnosis of HCV to treatment, and characteristics of treated vs untreated patients. METHODS: US administrative claims analysis using the Optum Research Database identified adults diagnosed with HCV from July 1, 2016 through September 30, 2020. Index date was the first diagnosis of HCV based on ICD-9/10 CM codes. Continuous enrollment 12 months before and ≥ 1 month after the index date was required. Patients were followed until the earlier of disenrollment from the health plan or end of study period (October 31, 2020). Study measures included demographics, liver severity, comorbidities, index provider specialty, and health care utilization. Descriptive and multivariable analyses were conducted to evaluate the association between patient characteristics and the rate of treatment. RESULTS: 24,374 HCV patients met all inclusion criteria, of whom, only 30% initiated treatment post diagnosis during the follow-up. On average, patients initiated treatment 168 days after diagnosis and among patients with 12 months of follow-up, 28% initiated treatment within 12 months of diagnosis. The 3 most common treatment regimens were sofosbuvir & ledipasvir (37%), sofosbuvir & velpatasvir (30%), and glecaprevir & pibrentasvir (28%). In comparison to untreated patients, treated patients were more likely to be younger, (59 vs 62 years on average; P < 0.01) and commercially insured (51% vs 34%; P < 0.01). Treated patients were less likely to have cirrhosis, liver transplant or hepatocellular carcinoma during the 12-month pre-index baseline (2% vs 8%; P < 0.01). Similar results were observed from multivariable modeling with younger age categories vs pts > 75 years old (HR = 1.50-1.83), commercial vs Medicare Advantage (HR = 1.32), diagnosis by a specialist (HR = 2.56-2.62) associated with increased rate of treatment (P < 0.01). Baseline cirrhosis (HR = 0.42) and drug use disorders (HR = 0.85) were associated with lower rate of treatment (P < 0.01). CONCLUSIONS: Despite the availability of direct acting antiviral medications, a large proportion of HCV patients (70%) remain untreated. Identifying subgroups of the population who remain untreated may help physicians develop interventions and target patients who may benefit from treatment.

PubMed ID

Not assigned.

Volume

28

Issue

3-A

First Page

S9

Last Page

S10

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