Patterns in Liver-Related Health Outcomes with Hepatitis C Virus Treatments and Health Equity Implications for Decision Makers: A Cohort Analysis of Medicaid Patients
Introduction: Hepatitis C virus (HCV) infection is a blood-borne communicable disease that, in perhaps 20% of cases, results in a chronic disease. However, traditional peginterferon/ribavirin therapies pose many adverse side effects that are difficult to tolerate, and many patients do not complete t...
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| Format: | Article |
| Language: | English |
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Mary Ann Liebert
2017-09-01
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| Series: | Health Equity |
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| Online Access: | https://www.liebertpub.com/doi/full/10.1089/HEQ.2017.0018 |
| _version_ | 1827386991796289536 |
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| author | S. Mantravadi |
| author_facet | S. Mantravadi |
| author_sort | S. Mantravadi |
| collection | DOAJ |
| description | Introduction: Hepatitis C virus (HCV) infection is a blood-borne communicable disease that, in perhaps 20% of cases, results in a chronic disease. However, traditional peginterferon/ribavirin therapies pose many adverse side effects that are difficult to tolerate, and many patients do not complete the therapy. However, healthcare access to these newer, efficacious treatments are reduced, due to inadequate or lack of coverage of direct acting antiviral (DAA) medication. The objective of this study was to evaluate the impact of HCV treatment regimens on outcomes of care for HCV-infected Medicaid beneficiaries without cirrhosis/liver disease scarring.
Methods: A cohort analysis was performed to evaluate the changes in cirrhosis, hepatocellular carcinoma (liver cancer), and liver transplantation with use of HCV treatments in Medicaid beneficiaries with HCV, and was followed over a period of 10 years. The cohort of Medicaid beneficiaries and relevant variables were generated from published literature.
Results: Finally, considering the impact on health expenditures due to improved access to new treatments in Medicaid beneficiaries, DAAs resulted in the lowest decompensated cirrhosis and hepatocellular carcinoma-related healthcare cost per person over the 10-year time frame the cohort was followed.
Conclusions: The risk of liver-related disease is higher in patients with cirrhosis, as reaching treatment success results in continued disease progression, not normal health status; thus, liver cancer healthcare costs are higher in patients with cirrhosis, compared to those without cirrhosis. |
| first_indexed | 2024-03-08T15:54:29Z |
| format | Article |
| id | doaj.art-39f5bbbf0a2847a4a4c587c01163d488 |
| institution | Directory Open Access Journal |
| issn | 2473-1242 |
| language | English |
| last_indexed | 2024-03-08T15:54:29Z |
| publishDate | 2017-09-01 |
| publisher | Mary Ann Liebert |
| record_format | Article |
| series | Health Equity |
| spelling | doaj.art-39f5bbbf0a2847a4a4c587c01163d4882024-01-08T21:03:03ZengMary Ann LiebertHealth Equity2473-12422017-09-011115616410.1089/HEQ.2017.0018Patterns in Liver-Related Health Outcomes with Hepatitis C Virus Treatments and Health Equity Implications for Decision Makers: A Cohort Analysis of Medicaid PatientsS. Mantravadi0University of West FloridaIntroduction: Hepatitis C virus (HCV) infection is a blood-borne communicable disease that, in perhaps 20% of cases, results in a chronic disease. However, traditional peginterferon/ribavirin therapies pose many adverse side effects that are difficult to tolerate, and many patients do not complete the therapy. However, healthcare access to these newer, efficacious treatments are reduced, due to inadequate or lack of coverage of direct acting antiviral (DAA) medication. The objective of this study was to evaluate the impact of HCV treatment regimens on outcomes of care for HCV-infected Medicaid beneficiaries without cirrhosis/liver disease scarring. Methods: A cohort analysis was performed to evaluate the changes in cirrhosis, hepatocellular carcinoma (liver cancer), and liver transplantation with use of HCV treatments in Medicaid beneficiaries with HCV, and was followed over a period of 10 years. The cohort of Medicaid beneficiaries and relevant variables were generated from published literature. Results: Finally, considering the impact on health expenditures due to improved access to new treatments in Medicaid beneficiaries, DAAs resulted in the lowest decompensated cirrhosis and hepatocellular carcinoma-related healthcare cost per person over the 10-year time frame the cohort was followed. Conclusions: The risk of liver-related disease is higher in patients with cirrhosis, as reaching treatment success results in continued disease progression, not normal health status; thus, liver cancer healthcare costs are higher in patients with cirrhosis, compared to those without cirrhosis.https://www.liebertpub.com/doi/full/10.1089/HEQ.2017.0018hepatitis CMedicaidhealth equity |
| spellingShingle | S. Mantravadi Patterns in Liver-Related Health Outcomes with Hepatitis C Virus Treatments and Health Equity Implications for Decision Makers: A Cohort Analysis of Medicaid Patients Health Equity hepatitis C Medicaid health equity |
| title | Patterns in Liver-Related Health Outcomes with Hepatitis C Virus Treatments and Health Equity Implications for Decision Makers: A Cohort Analysis of Medicaid Patients |
| title_full | Patterns in Liver-Related Health Outcomes with Hepatitis C Virus Treatments and Health Equity Implications for Decision Makers: A Cohort Analysis of Medicaid Patients |
| title_fullStr | Patterns in Liver-Related Health Outcomes with Hepatitis C Virus Treatments and Health Equity Implications for Decision Makers: A Cohort Analysis of Medicaid Patients |
| title_full_unstemmed | Patterns in Liver-Related Health Outcomes with Hepatitis C Virus Treatments and Health Equity Implications for Decision Makers: A Cohort Analysis of Medicaid Patients |
| title_short | Patterns in Liver-Related Health Outcomes with Hepatitis C Virus Treatments and Health Equity Implications for Decision Makers: A Cohort Analysis of Medicaid Patients |
| title_sort | patterns in liver related health outcomes with hepatitis c virus treatments and health equity implications for decision makers a cohort analysis of medicaid patients |
| topic | hepatitis C Medicaid health equity |
| url | https://www.liebertpub.com/doi/full/10.1089/HEQ.2017.0018 |
| work_keys_str_mv | AT smantravadi patternsinliverrelatedhealthoutcomeswithhepatitiscvirustreatmentsandhealthequityimplicationsfordecisionmakersacohortanalysisofmedicaidpatients |