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[Hepatitis C in Germany: an analysis of statutory sickness funds claims data]
Jörg Tomeczkowski1, Markus Cornberg2
1Janssen-Cilag GmbH, Abteilung Health Economics, Neuss.
Insights
Approximately 50% of Hepatitis C Virus (HCV) patients sought medical attention over three years, with only 9% receiving treatment annually. Treatment adherence and diagnostic practices for HCV varied between general practitioners and specialists, indicating a need for specialized care.
Area of Science:
- Hepatology
- Infectious Diseases
- Public Health
Background:
- Investigating patient access to medical care for Hepatitis C Virus (HCV).
- Assessing the healthcare system's supply for managing HCV infections, including therapy and lab monitoring.
Purpose of the Study:
- To determine the number of individuals seeking medical attention for Hepatitis C Virus (HCV).
- To provide an overview of treatment and laboratory control frequencies for HCV patients.
Main Methods:
- Analysis of data from statutory health insurance providers.
Main Results:
- HCV diagnosis prevalence was 0.19% over three years.
- 19% of positive HCV tests resulted in an acute HCV diagnosis documentation.
- In 2008, 9.3% of patients received pegylated Interferon alpha-based therapy (11.9% for chronic, 3.6% for acute HCV).
- General practitioners initiated therapy in 5.1% of cases, while specialists initiated in 21.7% within a year.
- Treatment prescription adherence varied, with 37.0% of GP-treated and 57.0% of specialist-treated patients receiving prescriptions in the third quarter post-initiation.
- Pre-therapy viral load testing was not consistently documented.
Conclusions:
- Half of HCV patients consulted a physician within three years, but only 9% received therapy annually.
- Deviations from guidelines and disparities between general practitioners and specialists were observed in acute HCV diagnosis coding, therapy duration, and pre-therapy viral load testing.
- Centralizing HCV treatment in specialized centers is recommended to optimize therapy efficacy within the healthcare system.
Background:
The aim of this study was to investigate the number of persons who obtain medical attention for Hepatitis C Virus (HCV). In addition, we wanted to get an overview of the supply situation (frequency and length of therapy or lab controls) for patients with HCV infection.
Methodology:
Data obtained from statutory insurance companies were analyzed.
Results:
The prevalence of HCV diagnosis was 0.19 % within 3 years. Following a positive HCV-test in 19 % of patients the diagnosis of acute HCV was documented. In 2008, 9.3 % of patients were treated with pegylated Interferon alpha with or without Ribavirin (11.9 % for chronic and 3.6 % for acute HCV). A general practitioner initiated in about 5.1 % and a specialist in 21.7 % of cases a therapy within a year. 37.0 % of patients treated by a general practitioner and 57.0 % of patients treated by specialists received prescriptions in the third quarter after initiating the therapy. Not all patients had a documented test for viral load prior to therapy.
Conclusions:
50 % of HCV-patients visited a physician in a 3 year time period while an average of 9 % received a therapy within a year. For the coding of acute HCV diagnosis, duration of therapy and the necessary viral load test prior therapy, the analyses showed deviations from the guideline and differences between general practitioners and specialists. For future therapies, patients with HCV-infection should be treated in specialized centers so that these therapies may develop their efficiency in the health system.
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