Clinical, Economic, and Humanistic Impact of Sofosbuvir-Based Regimens in Hepatitis C

Mousam Parekh

Defense Date

10-29-2015

Graduation Date

Fall 1-1-2015

Availability

Immediate Access

Submission Type

thesis

Degree Name

MS

Department

Pharmacy Administration

School

School of Pharmacy

Committee Chair

Khalid Kamal

Committee Member

Pamela Koerner

Committee Member

Richard Miller

Committee Member

Vincent Giannetti

Keywords

Clinical, Cost-effectiveness, Hepatitis C, Sofosbuvir

Abstract

Objective: A retrospective data analysis was conducted on real-world data for treatment-naïve and treatment-experienced patients with hepatitis C. Real-world effectiveness values were used to populate an economic model for genotype 1 patients with hepatitis C.

Methods: De-identified data of patients using FDA-approved, sofosbuvir-based regimens from Walgreens Specialty Pharmacy (December 2013 – April 30, 2015) was utilized. The study was conducted in two phases. In Phase I, an economic model was adapted from literature to estimate real-world cost effectiveness ratios of sofosbuvir-based regimens compared to telaprevir-based regimen. Real-world effectiveness values derived from Phase II analysis was used to populate the economic model. In Phase II, descriptive analyses were conducted to evaluate treatment utilization patterns of sofosbuvir-based regimens. Medication adherence was assessed using pharmacy refill data by medication possession ratio and proportion of days covered methods. Factors associated with treatment discontinuation were also assessed.

Results: Sofosbuvir-based regimens led to cost savings for treatment-naïve and treatment-experienced genotype 1 patients compared to telaprevir-based regimen. The majority of patients in this study were adherent to sofosbuvir-based regimens and the overall discontinuation rates in the study were low. Of the patients that discontinued therapy, the primary reported reasons were side effects and insurance coverage issues. Treatment discontinuation due to side effects was highest in patients using peg-interferon-based, sofosbuvir regimen.

Conclusions: Sofosbuvir-based regimens are cost-effective, with most patients being adherent to their regimen in this real-world study.

Format

PDF

Language

English

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