Assessing Patient Preferences for Treatment Decisions for New Direct Acting Antiviral (DAA) Therapies for Chronic Hepatitis C Virus Infections

Abstract

IntroductionThe new direct acting antiviral (DAA) therapies are able to effectively treat chronic hepatitis C (CHC). This study elicited the preferences of CHC patients for treatment attributes of new DAAs.MethodsAn online discrete choice experiment survey was designed to collect data from adult CHC patients in the USA, UK, France, Germany, Spain, and Italy. Patients were asked to choose from alternative hypothetical DAA options, defined by differing levels of nine attributes [i.e., treatment duration, tablet count and packaging, cure rate, required office visits when on treatment, modifications to statins or to proton pump inhibitors (PPIs), and risks of diarrhea, headache and nausea]. Logistic regression was used to assess preference for the treatment options.ResultsA total of 328 patients with CHC completed the survey (USA, n = 227; European countries, n = 101), with a mean age of 47.7 years (SD = 14.4) and an average 11.2 years since CHC diagnosis; 51% of patients were female. More than half (60%) of the patients had treatment for CHC. Patients significantly preferred a DAA regimen with higher cure rate, shorter treatment duration, lower risks of diarrhea, headache, and nausea (all p < 0.001), reduced need for office visits when on treatment (p = 0.044), and without requiring dose reduction or timing change in PPIs (p = 0.032). Tablet counts were not found to be statistically significant.ConclusionGiven the overall high cure rates of new DAAs, CHC patients’ preferences for therapy may be influenced by treatment attributes other than cure rates and tolerability. Treatments that are more convenient and require less disruption to their daily life (e.g., shorter treatment duration, no modification in PPI use, and fewer office visits when on treatment) are important to patients with CHC and should be considered when making treatment decisions.FundingAbbVie.

Real-World Clinical Practice Use of 8-Week Glecaprevir/Pibrentasvir in Treatment-Naïve Patients with Compensated Cirrhosis

“…Although similar high SVR12 rates are observed for the 12-week G/P regimen, patients may prefer a shorter duration because it is more convenient and requires less monitoring [9]. requested by any qualified researchers who engage in rigorous, independent scientific research, and will be provided following review and approval of a research proposal and Statistical Analysis Plan (SAP) and execution of a Data Sharing Agreement (DSA).…”

“…In the USA, TN patients without cirrhosis and with CC represent 98% of the HCV patient population [ 16 ]; therefore, the majority of patients are eligible for 8-week treatment. Although similar high SVR12 rates are observed for the 12-week G/P regimen, patients may prefer a shorter duration because it is more convenient and requires less monitoring [ 9 ].…”

“…Increasing the number of patients eligible for the shorter 8-week treatment with G/P has the potential to reach newly diagnosed TN patients by addressing barriers in the care cascade. It may also potentially offer additional advantages such as improved patient uptake [9] due to reduced treatment duration and monitoring, as well as improved adherence in patients who use drugs [10]. This review of data from seven separate cohort studies aims to summarize newly emerging data on TN patients with CC (Child-Pugh A) and HCV treated in real-world clinical practice with 8 weeks of G/P treatment and to further understand where additional real-world data are needed for newly diagnosed patients with HCV across multiple populations.…”

Effectiveness of 8-Week Glecaprevir/Pibrentasvir for Treatment-Naïve, Compensated Cirrhotic Patients with Chronic Hepatitis C Infection

“…The World Health Organization has established targets for HCV elimination by 2030; however, current rates of HCV treatment have been declining in the US, which can be Given the similar high cure rates and safety profiles of contemporary HCV regimens, HCV patients' preferences for therapy may be influenced by treatment attributes other than cure rates and tolerability. Treatments that are more convenient and require less disruption to their daily life (e.g., shorter treatment duration, no modification in PPI use, and fewer office visits when on treatment) are important to patients with HCV and should be considered when making treatment decisions [15].…”

Results from a prospective study of individuals' symptoms and patient activation after hepatitis C treatment

“…In addition, only one study has focused on the level of engagement of individuals with HCV in their treatment regimen or levels of patient activation. Welzel et al (2019) found that approximately 20% of HCV patients studied may lack the basic knowledge and confidence to be an active participant in their health care. Because the antiviral medication treatment is complex, including laboratory blood draws and clinic visits, patient adherence is critical to achieving a sustained virologic response.…”