Adoption of direct-acting antiviral medications for hepatitis C: a retrospective observational study.

Journal Article (Journal Article)

BACKGROUND: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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. TRIAL REGISTRATION: Not applicable.

Full Text

Duke Authors

Cited Authors

  • Zullig, LL; Bhatia, HL; Gellad, ZF; Eatherly, M; Henderson, R; Bosworth, HB

Published Date

  • July 25, 2019

Published In

Volume / Issue

  • 19 / 1

Start / End Page

  • 521 -

PubMed ID

  • 31345218

Pubmed Central ID

  • PMC6657375

Electronic International Standard Serial Number (EISSN)

  • 1472-6963

Digital Object Identifier (DOI)

  • 10.1186/s12913-019-4349-x


  • eng

Conference Location

  • England