Adoption of direct-acting antiviral medications for hepatitis C: a retrospective observational study
Abstract Background Approximately 3.5 million Americans are infected with the hepatitis C virus (HCV). Although many patients with HCV are asymptomatic, HCV is the leading cause of infection-related death in the U.S. With advances in curative medication therapy for HCV, many of these deaths are prev...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-07-01
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| Series: | BMC Health Services Research |
| Online Access: | http://link.springer.com/article/10.1186/s12913-019-4349-x |
| _version_ | 1818118222454456320 |
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| author | Leah L. Zullig Haresh L. Bhatia Ziad F. Gellad Mark Eatherly Rochelle Henderson Hayden B. Bosworth |
| author_facet | Leah L. Zullig Haresh L. Bhatia Ziad F. Gellad Mark Eatherly Rochelle Henderson Hayden B. Bosworth |
| author_sort | Leah L. Zullig |
| collection | DOAJ |
| description | Abstract Background Approximately 3.5 million Americans are infected with the hepatitis C virus (HCV). Although many patients with HCV are asymptomatic, HCV is the leading cause of infection-related death in the U.S. With advances in curative medication therapy for HCV, many of these deaths are preventable. Access to innovative therapies may be unevenly distributed. Our objective was to describe medication prescribers’ adoption of innovative HCV pharmacotherapy across prescriber, geographical location, and time. Methods This is a retrospective, secondary data analysis among a national cohort of patients prescribed direct-acting antiviral HCV medications with curative intent. We assessed prescriptions by time, geographic location, and provider type. Results The peak of the adoption rate occurred within 45 days; nearly one-sixth of all prescribers had already prescribed one of the new drugs. Geographical regions (Midwest, South, and West all p ≥ 0.05) nor gender (p = 0.455) of a prescriber impacted adoption. Similarly, patient income did not influence the likelihood of a prescriber to adopt the new drugs earlier (p = 0.175). Gastroenterologists or hepatologists were more likely earlier adopters compared to primary care physicians (p = 0.01). Conclusions Because of the relative advantage of newer therapies, we anticipated that there would be an initial surge as early adopters prescribed the new medications and use would dwindle over time as the initial HCV cohort was cured. The data demonstrate that our hypothesis is essentially supported. There is a reduction in prescriptions at approximately 5 months post-approval and treatment is typically required for 3 months. There has been a surge in clinicians’ adoption of innovative HCV treatments. As patients are cured of their infection, we anticipate a decreased need for chronic management of HCV. Trial registration Not applicable. Keywords Dissemination researchHealth services researchInfectious diseaseHepatitis C |
| first_indexed | 2024-12-11T04:50:52Z |
| format | Article |
| id | doaj.art-16351bd2851449f4b81578d79fa51b66 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-11T04:50:52Z |
| publishDate | 2019-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-16351bd2851449f4b81578d79fa51b662022-12-22T01:20:24ZengBMCBMC Health Services Research1472-69632019-07-011911710.1186/s12913-019-4349-xAdoption of direct-acting antiviral medications for hepatitis C: a retrospective observational studyLeah L. Zullig0Haresh L. Bhatia1Ziad F. Gellad2Mark Eatherly3Rochelle Henderson4Hayden B. Bosworth5Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care CenterExpress Scripts Holding CompanyCenter of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care CenterExpress Scripts Holding CompanyExpress Scripts Holding CompanyCenter of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care CenterAbstract Background Approximately 3.5 million Americans are infected with the hepatitis C virus (HCV). Although many patients with HCV are asymptomatic, HCV is the leading cause of infection-related death in the U.S. With advances in curative medication therapy for HCV, many of these deaths are preventable. Access to innovative therapies may be unevenly distributed. Our objective was to describe medication prescribers’ adoption of innovative HCV pharmacotherapy across prescriber, geographical location, and time. Methods This is a retrospective, secondary data analysis among a national cohort of patients prescribed direct-acting antiviral HCV medications with curative intent. We assessed prescriptions by time, geographic location, and provider type. Results The peak of the adoption rate occurred within 45 days; nearly one-sixth of all prescribers had already prescribed one of the new drugs. Geographical regions (Midwest, South, and West all p ≥ 0.05) nor gender (p = 0.455) of a prescriber impacted adoption. Similarly, patient income did not influence the likelihood of a prescriber to adopt the new drugs earlier (p = 0.175). Gastroenterologists or hepatologists were more likely earlier adopters compared to primary care physicians (p = 0.01). Conclusions Because of the relative advantage of newer therapies, we anticipated that there would be an initial surge as early adopters prescribed the new medications and use would dwindle over time as the initial HCV cohort was cured. The data demonstrate that our hypothesis is essentially supported. There is a reduction in prescriptions at approximately 5 months post-approval and treatment is typically required for 3 months. There has been a surge in clinicians’ adoption of innovative HCV treatments. As patients are cured of their infection, we anticipate a decreased need for chronic management of HCV. Trial registration Not applicable. Keywords Dissemination researchHealth services researchInfectious diseaseHepatitis Chttp://link.springer.com/article/10.1186/s12913-019-4349-x |
| spellingShingle | Leah L. Zullig Haresh L. Bhatia Ziad F. Gellad Mark Eatherly Rochelle Henderson Hayden B. Bosworth Adoption of direct-acting antiviral medications for hepatitis C: a retrospective observational study BMC Health Services Research |
| title | Adoption of direct-acting antiviral medications for hepatitis C: a retrospective observational study |
| title_full | Adoption of direct-acting antiviral medications for hepatitis C: a retrospective observational study |
| title_fullStr | Adoption of direct-acting antiviral medications for hepatitis C: a retrospective observational study |
| title_full_unstemmed | Adoption of direct-acting antiviral medications for hepatitis C: a retrospective observational study |
| title_short | Adoption of direct-acting antiviral medications for hepatitis C: a retrospective observational study |
| title_sort | adoption of direct acting antiviral medications for hepatitis c a retrospective observational study |
| url | http://link.springer.com/article/10.1186/s12913-019-4349-x |
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