Direct-acting antiviral retreatment patterns for hepatitis C

Area of Science:

• Hepatology
• Pharmacoeconomics
• Public Health

Background:

• Direct-acting antivirals (DAAs) demonstrate high efficacy against hepatitis C virus (HCV).
• A subset of patients requires a second DAA regimen, yet retreatment patterns and predictors remain under-researched.
• Understanding retreatment is crucial for optimizing HCV treatment strategies.

Purpose of the Study:

• To investigate the patterns and identify predictors of DAA retreatment in a large, commercially insured US population.
• To analyze retreatment rates across different DAA agents.
• To characterize the patient population requiring DAA retreatment.

Main Methods:

• Retrospective cohort study using IBM MarketScan Commercial Claims and Encounters data (2013-2019).
• Analysis of retreatment patterns among 31,553 DAA users.
• Descriptive statistics to compare patient characteristics and identify retreatment risk factors.

Main Results:

• 3.2% (1,017/31,553) of DAA users required retreatment; 4.3% of re-treated patients received a third regimen.
• Average retreatment cost was $109,683, with $1,287 out-of-pocket.
• Patients needing retreatment had higher rates of hypertension, diabetes, coagulopathy, anemia, alcohol abuse, prior liver transplant, and hepatocellular carcinoma.

Conclusions:

• Hepatitis C virus retreatment with DAAs, while infrequent, incurs significant costs for payers and patients.
• Comorbidities and indicators of severe liver disease are associated with higher retreatment risk.
• Proactive monitoring of high-risk patients may help manage retreatment needs.