A Retrospective analysis of costs and trends in the treatment of HCV in the setting of specialty pharmacy

Abstract

Specific Aims: The goal is to determine the incidence of therapy failures in Hepatitis C Virus (HCV) by viral genotype (GT), the costs of therapy, and to investigate trends or specific viral genotypes causing a higher incidence of failure in therapy. Subjects: Patients had to be over 18 and had to have started therapy for HCV at any point during 2018. Patients were excluded from analysis if they did not have a definitive follow-up SVR result reported back to the treating pharmacy. Methods: Data was collected through retrospective chart review and de-identified by pharmacy staff. Demographic data, clinical comorbidities and the length and choice of drug therapy was collected. Data was then analyzed through application of Chi-square and one-way ANOVA. Main Results: Subjects (n=604) on average were 59.2 (±11.6) years of age, with a majority (56%) being of the GT1a. Gender was significantly different between GTs (P<0.05), 1A being primarily male (60% vs 40%) and 3 being higher in female patients (56% vs 44%). GT3 had a significantly lower rate of therapy success (91%, P<0.05). The cost of HCV therapy was not significantly different between GT groups despite a significant difference in choice of therapy (P<0.001). Stratified by GT, the only significant patient factors include average age (P<0.001) and the presence of hypertension (P<0.05), GT1b being the highest in these categories. Conclusions: GT3 had the lowest incidence of therapy success. Analysis of patient factors does not clearly explain this phenomenon, and may be due solely to the viral genotype. The cost of therapy is found to be even amongst GT groups. Additional research may be done to investigate GT groups 4, 5 and 6, or focus on patients who have failed previous HCV therapy.