James G Orr1,2, Craig J Currie3,4, Ellen Berni4, Anurag Goel5, Kieran J Moriarty5, Ashish Sinha6, Fiona Gordon6, Anne Dethier7, John F Dillon7, Katie Clark8, Paul Richardson8, Paul Middleton9, Vishal Patel9, Debbie Shawcross9, Helen Preedy10, Richard J Aspinall10, Mark Hudson1,2. 1. Liver Unit, Freeman Hospital, Newcastle upon Tyne, UK. 2. Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK. 3. Cochrane Institute, School of Medicine, Cardiff University, Cardiff, UK. 4. Pharmatelligence, Cardiff, UK. 5. Gastroenterology, Royal Bolton Hospital, Bolton, UK. 6. Liver Unit, Bristol Royal Infirmary, Bristol, UK. 7. Gastroenterology, Ninewells Hospital, Dundee, UK. 8. Gastroenterology, The Royal Liverpool University Hospital, Liverpool, UK. 9. Institute of Liver Studies and Transplantation, King's College London School of Medicine, King's College Hospital, London, UK. 10. Gastroenterology and Hepatology, Queen Alexandra Hospital, Portsmouth, UK.
Abstract
BACKGROUND & AIMS: Rifaximin-α reduces the risk of recurrence of overt hepatic encephalopathy. However, there remain concerns regarding the financial cost of the drug. We aimed to study the impact of treatment with rifaximin-α on healthcare resource utilisation using data from seven UK liver treatment centres. METHODS: All seven centres agreed a standardised data set and data characterising clinical, demographic and emergency hospital admissions were collected retrospectively for the time periods 3, 6 and 12 months before and following initiation of rifaximin-α. Admission rates and hospital length of stay before and during therapy were compared. Costs of admissions and drug acquisition were estimated using published sources. Multivariate analyses were carried out to assess the relative impact of various factors on hospital length of stay. RESULTS: Data were available from 326 patients. Following the commencement of rifaximin, the total hospital length of stay reduced by an estimated 31-53%, equating to a reduction in inpatient costs of between £4858 and £6607 per year. Taking into account drug costs of £3379 for 1-year treatment with rifaximin-α, there was an estimated annual mean saving of £1480-£3228 per patient. CONCLUSIONS: Initiation of treatment with rifaximin-α was associated with a marked reduction in the number of hospital admissions and hospital length of stay. These data suggest that treatment of patients with rifaximin-α for hepatic encephalopathy was generally cost saving.
BACKGROUND & AIMS: Rifaximin-α reduces the risk of recurrence of overt hepatic encephalopathy. However, there remain concerns regarding the financial cost of the drug. We aimed to study the impact of treatment with rifaximin-α on healthcare resource utilisation using data from seven UK liver treatment centres. METHODS: All seven centres agreed a standardised data set and data characterising clinical, demographic and emergency hospital admissions were collected retrospectively for the time periods 3, 6 and 12 months before and following initiation of rifaximin-α. Admission rates and hospital length of stay before and during therapy were compared. Costs of admissions and drug acquisition were estimated using published sources. Multivariate analyses were carried out to assess the relative impact of various factors on hospital length of stay. RESULTS: Data were available from 326 patients. Following the commencement of rifaximin, the total hospital length of stay reduced by an estimated 31-53%, equating to a reduction in inpatient costs of between £4858 and £6607 per year. Taking into account drug costs of £3379 for 1-year treatment with rifaximin-α, there was an estimated annual mean saving of £1480-£3228 per patient. CONCLUSIONS: Initiation of treatment with rifaximin-α was associated with a marked reduction in the number of hospital admissions and hospital length of stay. These data suggest that treatment of patients with rifaximin-α for hepatic encephalopathy was generally cost saving.
Authors: Jasmohan S Bajaj; Jacqueline G O'Leary; Puneeta Tandon; Florence Wong; Patrick S Kamath; Scott W Biggins; Guadalupe Garcia-Tsao; Jennifer Lai; Michael B Fallon; Paul J Thuluvath; Hugo E Vargas; Benedict Maliakkal; Ram M Subramanian; Leroy R Thacker; K Rajender Reddy Journal: Aliment Pharmacol Ther Date: 2019-04-29 Impact factor: 8.171
Authors: Jasmohan S Bajaj; Puneeta Tandon; Jacqueline G OʼLeary; Florence Wong; Scott W Biggins; Guadalupe Garcia-Tsao; Patrick S Kamath; Benedict Maliakkal; Michael B Fallon; Jennifer C Lai; Paul J Thuluvath; Hugo E Vargas; Ram M Subramanian; Leroy R Thacker; K Rajender Reddy Journal: Am J Gastroenterol Date: 2019-04 Impact factor: 10.864
Authors: Mark Hudson; Amr Radwan; Paola Di Maggio; Riccardo Cipelli; Stephen D Ryder; John F Dillon; William Jonathan Cash; Robert T Przemioslo; Mark Wright; Debbie L Shawcross; Rajiv Jalan; Sushma Saksena; Michael Allison; Paul Richardson; Elizabeth Farrington; Richard J Aspinall Journal: Frontline Gastroenterol Date: 2017-04-07