Onur Baser1, Akif Altinbas2, Erdem Baser3, M Furaha Kariburyo4. 1. Department of Surgery, Center for Innovation and Outcomes Research, Columbia University, New York, NY, USA; Department of Economics, MEF University, Istanbul, Turkey; STATinMED Research, New York, NY, USA. Electronic address: obaser@statinmed.com. 2. Diskapi Yildirim Beyazit Education and Research Hospital, Gastroenterology Clinic, Ankara, Turkey. 3. Department of Economics, Gazi University, Ankara, Turkey. 4. STATinMED Research, Ann Arbor, MI, USA.
Abstract
BACKGROUND: According to the Turkish Ministry of Health's guidelines, standard double therapy, a combination of pegylated interferon-alpha and ribavirin, was the only treatment option for patients with hepatitis C virus (HCV) infection until the end of 2011. OBJECTIVE: The primary objective was to compare risk-adjusted clinical and economic outcomes between treated and untreated patients with HCV infection. METHODS: Patients with HCV infection were identified from the Turkish National Health Insurance Database (2009-2011) using International Classification of Diseases, 10th Revision, Clinical Modification codes. The first prescription date was designated as the index date. Mortality and hepatocellular carcinoma (HCC) rates and health care costs of treated and untreated patients were compared using propensity score matching. Baseline demographic and clinical factors were controlled in the models. Subgroup analysis was conducted for patient groups with and without a cirrhosis diagnosis. RESULTS: Out of 12,990 patients included in the study, 1,583 were treated for HCV infection. Out of 2,467 patients who had a cirrhosis diagnosis, 231 were treated, whereas out of 10,523 patients without cirrhosis, 1,352 patients were treated. Treated patients were younger, less likely to be diagnosed with comorbid conditions, and less likely to reside in Central or Eastern Anatolia. After adjusting for baseline demographic and clinical factors, mortality (2.27% vs. 5.31%; P < 0.001) and HCC rates (0.69% vs. 1.96%; P < 0.001) were found to be lower for treated patients. Differences were more significant among patients diagnosed with cirrhosis. Treated patients incurred higher risk-adjusted annual costs (€6172 vs. €1680; P < 0.001), mainly because of pharmaceutical costs (€4918 vs. €583; P < 0.001). CONCLUSIONS: HCV infection treatment, although costly, significantly reduces mortality and HCC rates in Turkey.
BACKGROUND: According to the Turkish Ministry of Health's guidelines, standard double therapy, a combination of pegylated interferon-alpha and ribavirin, was the only treatment option for patients with hepatitis C virus (HCV) infection until the end of 2011. OBJECTIVE: The primary objective was to compare risk-adjusted clinical and economic outcomes between treated and untreated patients with HCV infection. METHODS:Patients with HCV infection were identified from the Turkish National Health Insurance Database (2009-2011) using International Classification of Diseases, 10th Revision, Clinical Modification codes. The first prescription date was designated as the index date. Mortality and hepatocellular carcinoma (HCC) rates and health care costs of treated and untreated patients were compared using propensity score matching. Baseline demographic and clinical factors were controlled in the models. Subgroup analysis was conducted for patient groups with and without a cirrhosis diagnosis. RESULTS: Out of 12,990 patients included in the study, 1,583 were treated for HCV infection. Out of 2,467 patients who had a cirrhosis diagnosis, 231 were treated, whereas out of 10,523 patients without cirrhosis, 1,352 patients were treated. Treated patients were younger, less likely to be diagnosed with comorbid conditions, and less likely to reside in Central or Eastern Anatolia. After adjusting for baseline demographic and clinical factors, mortality (2.27% vs. 5.31%; P < 0.001) and HCC rates (0.69% vs. 1.96%; P < 0.001) were found to be lower for treated patients. Differences were more significant among patients diagnosed with cirrhosis. Treated patients incurred higher risk-adjusted annual costs (€6172 vs. €1680; P < 0.001), mainly because of pharmaceutical costs (€4918 vs. €583; P < 0.001). CONCLUSIONS:HCV infection treatment, although costly, significantly reduces mortality and HCC rates in Turkey.
Authors: Akif Altinbas; Jacinta A Holmes; Shadi Salloum; Anna Lidofsky; Nadia Alatrakchi; Ma Somsouk; Peter Hunt; Steven Deeks; Kara W Chew; Georg Lauer; Annie Kruger; Wenyu Lin; Raymond T Chung Journal: Biomark Med Date: 2022-07-05 Impact factor: 2.498