University of Hawaii, 642 Ulukahiki St #103, Kailua, HI 96734. Email:
Am J Manag Care. 2019 Jul;25(7):319-323.
We analyzed the demographics and disease characteristics of patients prescribed treatment for chronic hepatitis C virus (HCV) infection from 2013 through 2017, a time frame that encompasses the expansion of available direct-acting antiviral inhibitors.
Retrospective analysis.
Using a proprietary disease-management program, data for 19,944 patients receiving HCV treatment were collected from providers and specialty pharmacies. Six-month time periods accounting for introductions of novel treatments were established as follows: December 2013 to May 2014 (n = 1438), simeprevir and sofosbuvir; October 2014 to March 2015 (n = 2242), ledipasvir/sofosbuvir and ombitasvir/paritaprevir/ritonavir plus dasabuvir; October 2015 to March 2016 (n = 5514), daclatasvir; July 2016 to December 2016 (n = 5562), elbasvir/grazoprevir and sofosbuvir/velpatasvir; and July 2017 to December 2017 (n = 5188), sofosbuvir/velpatasvir/voxilaprevir and glecaprevir/pibrentasvir. Changes over time were evaluated for statistical significance.
In the 2013-2014 time period, 44% of patients receiving prescriptions for HCV treatment were treatment-experienced and 45% had cirrhosis. By 2017, only 14% were treatment-experienced (P <.001) and 21% had cirrhosis (P <.001). The percentage of patients with HCV genotype 1 increased from 69% to 87% from 2013-2014 to 2014-2015 (P <.001) but subsequently decreased to 74% in 2017 (P <.001). The percentage of patients receiving HCV prescriptions in an academic setting declined from 61% in 2013-2014 to 13% in 2017 (P <.001).
In the United States, since the introduction of interferon-free HCV regimens, the patient population prescribed treatment has changed, becoming predominantly treatment-naïve, without cirrhosis, and treated in nonacademic centers.
我们分析了 2013 年至 2017 年间接受慢性丙型肝炎病毒（HCV）感染治疗的患者的人口统计学和疾病特征，这一时间范围涵盖了可用直接作用抗病毒抑制剂的扩展。
回顾性分析。
使用专有的疾病管理计划，从提供者和专业药房收集了 19944 名接受 HCV 治疗的患者的数据。建立了以下新型治疗方法引入的六个月时间段：2013 年 12 月至 2014 年 5 月（n = 1438），simeprevir 和 sofosbuvir；2014 年 10 月至 2015 年 3 月（n = 2242），ledipasvir/sofosbuvir 和 ombitasvir/paritaprevir/ritonavir 加 dasabuvir；2015 年 10 月至 2016 年 3 月（n = 5514），daclatasvir；2016 年 7 月至 2016 年 12 月（n = 5562），elbasvir/grazoprevir 和 sofosbuvir/velpatasvir；2017 年 7 月至 2017 年 12 月（n = 5188），sofosbuvir/velpatasvir/voxilaprevir 和 glecaprevir/pibrentasvir。评估了随时间的变化是否具有统计学意义。
在 2013-2014 时间段，44%接受 HCV 治疗处方的患者为治疗经验丰富，45%有肝硬化。到 2017 年，只有 14%是治疗经验丰富的（P <.001），21%有肝硬化（P <.001）。HCV 基因型 1 的患者比例从 2013-2014 年的 69%增加到 2014-2015 年的 87%（P <.001），但随后在 2017 年降至 74%（P <.001）。在美国，接受 HCV 处方的患者人群在学术环境中的比例从 2013-2014 年的 61%下降到 2017 年的 13%（P <.001）。
自无干扰素 HCV 方案推出以来，在美国，接受治疗的患者人群发生了变化，主要为无肝硬化、无治疗经验且在非学术中心接受治疗的患者。
