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American Journal of Health-System Pharmacy, Vol. 66, Issue 24, 2171-2178
Copyright © 2009. American Society of Health-System Pharmacists, Inc. All rights reserved. 1079-2082/04/0602-1242$06.00

Clinical Report

Treatment persistence in and cost of therapy for patients with chronic hepatitis C: Peginterferon alfa-2a plus ribavirin versus peginterferon alfa-2b plus ribavirin

 Diana I. Brixner, Xin Ye, Teng-Chiao Chu, William A. Blumentals and Tarek I. Hassanein

DIANA I. BRIXNER, PH.D., is Professor, Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City. XIN YE, M.S., PH.D., is Researcher, i3 Innovus, Eden Prairie, MN. TENG-CHIAO CHU, PH.D., is Therapeutic Area Director; and WILLIAM A. BLUMENTALS, PH.D., is Program Director, Roche, Nutley, NJ. TAREK I. HASSANEIN, M.D., is Professor, University of California—San Diego, San Diego.

Address correspondence to Dr. Brixner at the Department of Pharmacotherapy, College of Pharmacy, University of Utah, 30 South 2000 East, Room 258, Salt Lake City, UT 84112 (diana.brixner{at}utah.edu).


Purpose. 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.

Conclusion. 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.

Index terms: Antivirals; Combined therapy; Compliance; Costs; Drug comparisons; Hepatitis C; Patients; Peginterferon alfa-2a; Ribavirin

 

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