Author information
1
Epidemiology and Database Research, Maccabi Healthcare Services, Tel Aviv, Israel.
2
Health Economics and Outcomes Research, AbbVie, North Chicago, USA.
3
Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, USA.
4
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Abstract
Treatment with ombitasvir/paritaprevir/ritonavir and dasabuvir, with or without ribavirin (OPrD±RBV) was the first interferon-free direct-acting antiviral for hepatitis C virus (HCV) introduced to Israel's national basket of health services in February 2015. Patients with HCV genotype 1 (GT1) and advanced fibrosis (F3-F4) were eligible for treatment in 2015. This study aims to characterize patients initiating OPrD± RBV and assess sustained virological response (SVR). A retrospective cohort study was performed using the database of Maccabi Healthcare Services (MHS), a 2-million-member health plan in Israel. The study population included adults who initiated OPrD±RBV through December 2015 per health basket criteria. A gap in medication fills (>14 days between a fill's run-out and the next fill) was used to estimate adherence. SVR was defined by the viral tests at least 12 weeks post-treatment. The study population consisted of 403 patients (56.3% male), with a mean age of 60.7 years (SD 11.0). Overall, 71.0% were naïve to prior HCV treatment and 95.6% were treated with a 12-week regimen. A total of 348 patients (86.4%) completed the regimen in the usual time frame (highly adherent), whereas 8.2% completed with a gap, and 4.7% purchased less than the recommended dose. SVR rates overall and among highly adherent patients were 395/403 (98.0%; 95%CI 96.1-99.1%) and 346/348 (99.4%; 95%CI 97.9-99.9%), respectively. GT1b patients on 12-week regimens attained SVR rates of 194/196 (fibrosis F3) and 170/176 (cirrhosis). After a first year of provision of OPrD±RBV with good adherence, high SVR rates were achieved in various patient subgroups and comorbidities.