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

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          Abstract

          Introduction

          The 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.

          Methods

          An 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.

          Results

          A 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.

          Conclusion

          Given 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.

          Funding

          AbbVie.

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          Most cited references20

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          Development and testing of a short form of the patient activation measure.

          Judith Hibbard, Eldon R. Mahoney, Jean Stockard … (2005)
          The Patient Activation Measure (PAM) is a 22-item measure that assesses patient knowledge, skill, and confidence for self-management. The measure was developed using Rasch analyses and is an interval level, unidimensional, Guttman-like measure. The current analysis is aimed at reducing the number of items in the measure while maintaining adequate precision. We relied on an iterative use of Rasch analysis to identify items that could be eliminated without loss of significant precision and reliability. With each item deletion, the item scale locations were recalibrated and the person reliability evaluated to check if and how much of a decline in precision of measurement resulted from the deletion of the item. The data used in the analysis were the same data used in the development of the original 22-item measure. These data were collected in 2003 via a telephone survey of 1,515 randomly selected adults. Principal Findings. The analysis yielded a 13-item measure that has psychometric properties similar to the original 22-item version. The scores for the 13-item measure range in value from 38.6 to 53.0 (on a theoretical 0-100 point scale). The range of values is essentially unchanged from the original 22-item version. Subgroup analysis suggests that there is a slight loss of precision with some subgroups. The results of the analysis indicate that the shortened 13-item version is both reliable and valid.
          Article 0 comments Cited 671 times – based on 0 reviews     Review now
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            Chronic hepatitis C virus infection in the United States, National Health and Nutrition Examination Survey 2003 to 2010.

            Maxine Denniston, Ruth Jiles, Jan Drobeniuc … (2014)
            Knowledge of the number of persons with chronic hepatitis C virus (HCV) infection in the United States is critical for public health and policy planning. To estimate the prevalence of chronic HCV infection between 2003 and 2010 and to identify factors associated with this condition. Nationally representative household survey. U.S. noninstitutionalized civilian population. 30,074 NHANES (National Health and Nutrition Examination Survey) participants between 2003 and 2010. Interviews to ascertain demographic characteristics and possible risks and exposures for HCV infection. Serum samples from participants aged 6 years or older were tested for antibody to HCV; if results were positive or indeterminate, the samples were tested for HCV RNA, which indicates current chronic infection. Based on 273 participants who tested positive for HCV RNA, the estimated prevalence of HCV infection was 1.0% (95% CI, 0.8% to 1.2%), corresponding to 2.7 million chronically infected persons (CI, 2.2 to 3.2 million persons) in the U.S. noninstitutionalized civilian population. Infected persons were more likely to be aged 40 to 59 years, male, and non-Hispanic black and to have less education and lower family income. Factors significantly associated with chronic HCV infection were illicit drug use (including injection drugs) and receipt of a blood transfusion before 1992; 49% of persons with HCV infection did not report either risk factor. Incarcerated and homeless persons were not surveyed. This analysis estimated that approximately 2.7 million U.S. residents in the population sampled by NHANES have chronic HCV infection, about 500,000 fewer than estimated in a similar analysis between 1999 and 2002. These data underscore the urgency of identifying the millions of persons who remain infected and linking them to appropriate care and treatment. None.
            Article 0 comments Cited 207 times – based on 0 reviews     Review now
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              Glecaprevir–Pibrentasvir for 8 or 12 Weeks in HCV Genotype 1 or 3 Infection

              Stefan Zeuzem, Graham R. Foster, Stanley Wang … (2018)
              Article 0 comments Cited 154 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Yanjun Bao:
                ORCID: http://orcid.org/0000-0001-9589-6062
                carol.bao@abbvie.com
                Journal
                Journal ID (nlm-ta): Adv Ther
                Journal ID (iso-abbrev): Adv Ther
                Title: Advances in Therapy
                Publisher: Springer Healthcare (Cheshire )
                ISSN (Print): 0741-238X
                ISSN (Electronic): 1865-8652
                Publication date (Electronic): 25 June 2019
                Publication date PMC-release: 25 June 2019
                Publication date (Print): 2019
                Volume: 36
                Issue: 9
                Pages: 2475-2486
                Affiliations
                [1 ]GRID grid.7839.5, ISNI 0000 0004 1936 9721, J. W. Goethe University, ; Frankfurt, Germany
                [2 ]GRID grid.417986.5, ISNI 0000 0004 4660 9516, Analysis Group, Inc., ; Boston, MA USA
                [3 ]GRID grid.431072.3, ISNI 0000 0004 0572 4227, AbbVie Inc., ; North Chicago, IL USA
                [4 ]GRID grid.416167.3, Mount Sinai, ; New York, NY USA
                Author information
                http://orcid.org/0000-0001-9589-6062
                Article
                Publisher ID: 1012
                DOI: 10.1007/s12325-019-01012-6
                PMC ID: 6822851
                PubMed ID: 31240629
                SO-VID: 32bad73b-a94b-4527-ad24-e05b7502257c
                Copyright © © The Author(s) 2019
                License:

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                Date received : 3 April 2019
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100010878, AbbVie Biotherapeutics;
                Award ID: 1
                Award Recipient :
                Categories
                Subject: Original Research
                Custom metadata
                issue-copyright-statement © Springer Healthcare Ltd., part of Springer Nature 2019

                Keywords: chronic hepatitis c virus,dda,direct acting antiviral therapies,hcv,infectious diseases,patient preferences
                Data availability:
                Keywords: chronic hepatitis c virus, dda, direct acting antiviral therapies, hcv, infectious diseases, patient preferences

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