Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care Center, 411 West Chapel Hill Street, Suite 600, Durham, NC, 27701, USA.
Department of Population Health Sciences, Duke University Medical Center, Durham, NC, USA.
BMC Health Serv Res. 2019 Jul 25;19(1):521. doi: 10.1186/s12913-019-4349-x.
Approximately 3.5 million Americans are infected with the hepatitis C virus (HCV). Although many patients with HCV are asymptomatic, HCV is the leading cause of infection-related death in the U.S. With advances in curative medication therapy for HCV, many of these deaths are preventable. Access to innovative therapies may be unevenly distributed. Our objective was to describe medication prescribers' adoption of innovative HCV pharmacotherapy across prescriber, geographical location, and time.
This is a retrospective, secondary data analysis among a national cohort of patients prescribed direct-acting antiviral HCV medications with curative intent. We assessed prescriptions by time, geographic location, and provider type.
The peak of the adoption rate occurred within 45 days; nearly one-sixth of all prescribers had already prescribed one of the new drugs. Geographical regions (Midwest, South, and West all p ≥ 0.05) nor gender (p = 0.455) of a prescriber impacted adoption. Similarly, patient income did not influence the likelihood of a prescriber to adopt the new drugs earlier (p = 0.175). Gastroenterologists or hepatologists were more likely earlier adopters compared to primary care physicians (p = 0.01).
Because of the relative advantage of newer therapies, we anticipated that there would be an initial surge as early adopters prescribed the new medications and use would dwindle over time as the initial HCV cohort was cured. The data demonstrate that our hypothesis is essentially supported. There is a reduction in prescriptions at approximately 5 months post-approval and treatment is typically required for 3 months. There has been a surge in clinicians' adoption of innovative HCV treatments. As patients are cured of their infection, we anticipate a decreased need for chronic management of HCV.
Not applicable.
约有 350 万美国人感染了丙型肝炎病毒（HCV）。尽管许多 HCV 患者无症状，但 HCV 是美国感染相关死亡的主要原因。随着 HCV 治疗药物的进步，许多此类死亡是可以预防的。获得创新疗法的机会可能分布不均。我们的目的是描述药物提供者在全美范围内采用创新 HCV 药物治疗的情况，包括时间、地理位置和提供者类型。
这是一项对全国范围内接受直接作用抗病毒 HCV 药物治疗的患者进行的回顾性二次数据分析。我们根据时间、地理位置和提供者类型评估了处方。
采用率的高峰出现在 45 天内；近六分之一的开方医生已经开了一种新药。地理位置（中西部、南部和西部均 p≥0.05）或开方医生的性别（p=0.455）都没有影响采用率。同样，患者收入也没有影响开方医生更早采用新药的可能性（p=0.175）。与初级保健医生相比，胃肠病学家或肝病学家更有可能成为早期采用者（p=0.01）。
由于新疗法具有相对优势，我们预计早期采用者会开处方，随着初始 HCV 队列被治愈，新药物的使用会随着时间的推移而减少。数据表明，我们的假设基本得到支持。在获得批准后大约 5 个月，处方数量减少，治疗通常需要 3 个月。临床医生对创新 HCV 治疗方法的采用呈激增态势。随着患者感染得到治愈，我们预计对 HCV 慢性管理的需求将会减少。
不适用。
