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Factors Associated With Adherence to First-line Antiviral Therapy Among Commercially Insured Patients With Chronic

Jonathan D Alpern1,2, Heesoo Joo3, Nathan C Bahr4

  • 1Infectious Disease Section, Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA.

Open Forum Infectious Diseases
|April 3, 2023
PubMed

Insights

Longer prescription supplies of antiviral medications for chronic hepatitis B (CHB) improve patient adherence. Ninety-day or mixed-duration supplies are linked to better fill rates than 30-day supplies for entecavir and tenofovir disoproxil fumarate (TDF).

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Pharmacoepidemiology

Background:

  • Nonadherence to antiviral therapy poses risks for patients with chronic hepatitis B (CHB).
  • Understanding risk factors for nonadherence is crucial for improving clinical outcomes in CHB management.
  • This study examines adherence patterns among commercially insured CHB patients in the U.S.

Purpose of the Study:

  • To identify risk factors associated with antiviral therapy nonadherence in commercially insured patients with CHB.
  • To evaluate the impact of prescription supply duration on medication adherence for entecavir and tenofovir disoproxil fumarate (TDF).
  • To inform strategies for enhancing treatment adherence in CHB patients.

Main Methods:

  • Utilized a claims database to analyze data from commercially insured adult patients with CHB prescribed entecavir or TDF in 2019.
  • Defined adherence as a proportion of days covered (PDC) ≥80%.
  • Employed multivariate logistic regressions to calculate adjusted odds ratios (AORs) for adherence predictors.

Main Results:

  • Adherence rates were high: 83% for entecavir and 81% for TDF.
  • Ninety-day or mixed-duration supplies were associated with significantly higher adherence compared to 30-day supplies for both medications.
  • Factors like mail-order pharmacy use and high-deductible health plans also influenced adherence, while high out-of-pocket spending for TDF reduced adherence.

Conclusions:

  • Ninety-day and mixed-duration prescription supplies are associated with improved medication fill rates for entecavir and TDF in CHB patients.
  • Optimizing prescription supply strategies can enhance antiviral therapy adherence.
  • Addressing cost-related barriers, such as out-of-pocket spending, is vital for maintaining adherence to TDF.
Abstract

Keywords:
adherencedrug accesshealth outcomesinsuranceprescription drugs

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