PHARMACY COST OF MANAGING ANEMIA AMONG PATIENTS RECEIVING CHRONIC HEPATITIS C THERAPY

Tuesday, October 22, 2013
Key Ballroom Foyer (Hilton Baltimore)
Poster Board # P3-15
Applied Health Economics (AHE)

Tandon Neeta, Janssen Scientific Affairs, LLC, Titusville, NJ, Guy David, University of Pennsylvania, Philadelphia, PA, Michael Ryan, Statistical Solutions, Inc., Cincinnati, OH and Candace Gunnarsson, EdD, S2 Statistical Solutions, Inc., Cincinnati, OH
Purpose: Current treatment regimens for chronic Hepatitis C (CHC) contain the use of pegylated interferon and ribavirin, which may cause hematologic adverse events such as anemia, neutropenia, leukocytopenia, pancytopenia, and thrombocytopenia. CHC treatment associated anemia may not only result in dose reduction or discontinuation but may also increase pharmacy cost related to its management1. The objective of this research was to analyze pharmacy resource utilization and cost associated with management of anemia among patients receiving CHC treatment with pegylated interferon and ribavirin.

Method: This retrospective study used data from the OptumInsight Database from 01/01/2005-06/30/2012. Patients had a minimum of one diagnosis code of chronic or unspecified hepatitis C, had ≥1 NDC or J-Code for pegylated interferon and ribavarin, were ≥18 years at index medication date and had ≥12 months of continuous enrollment pre/post index medication date. Drug management cost of anemia was assessed for patients with at least 48 weeks of CHC treatment.

Result: There were 3,267 patients meeting inclusion criteria, with 819 (25%) on pegylated interferon and ribavirin therapy for at least 48 weeks. Mean age of the entire sample was 49.2 years, 64% were male, and >99% had commercial insurance. During the time on CHC treatment, the following hematologic adverse events were reported: anemia, neutropenia, leukocytopenia, pancytopenia, and thrombocytopenia. Of the 819 patients with ≥48 weeks of pegylated interferon and ribavirin therapy, 405 (49.5%) of patients experienced anemia, 134 (16.4%) experienced neutropenia and 127 (15.5%) experienced leukocytopenia, pancytopenia, or thrombocytopenia. Out of the 405 patients reporting anemia diagnoses, 185 had a record of Erythropoietin-stimulating agent usage, having an average pharmacy cost of $16,671 (SD $10,437) over the course of the CHC therapy and an average of $94.83 (SD $31.33) per day of anemia therapy.

Conclusion: Pharmacy cost to manage anemia may represent a significant part of the total cost of current CHC treatments. 

1Fried MW. Side effects of therapy of hepatitis C and their management. Hepatology 2002; 36(suppl 1):S237–S244.