Huge Gap Between Clinical Efficacy and Community Effectiveness in the Treatment of Chronic Hepatitis C. Issue 13 (April 2015)

• Record Type: Journal Article
• Authors: Yu, Ming-Lung; Yeh, Ming-Lun; Tsai, Pei-Chien; Huang, Ching-I.; Huang, Jee-Fu; Huang, Chung-Feng; Hsieh, Meng-Hsuan; Liang, Po-Cheng; Lin, Yi-Hung; Hsieh, Ming-Yen; Lin, Wen-Yi; Hou, Nai-Jen; Lin, Zu-Yau; Chen, Shinn-Cherng; Dai, Chia-Yen; Chuang, Wan-Long; Chang, Wen-Yu; Gonzalez., Stevan
• Is Part Of: Medicine. Volume 94:Issue 13(2015)
• Publication Date: 2015-04
• Subjects: Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000000690
• Languages: English
• ISSNs: 0025-7974

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Abstract</title> <p>Peginterferon/ribavirin provides a substantially high treatment efficacy for chronic hepatitis C virus (HCV) infections in Asians. Whether the clinical efficacy can be translated to community effectiveness remains unclear.</p> <p>The disease awareness, treatment accessibility, recommendations, acceptance, and barriers to anti-HCV treatment were explored to clarify the issue with a 3-step nationwide investigation in Taiwan. A crude HCV-infected population was estimated using databases from 3 large-scale surveillance studies and age-/geographic-specific population database. HCV awareness and accessibility were investigated at the patient level in 58, 129 residents. The recommendations/acceptances and barriers to treatment at the provider level were evaluated using a prospective, nationwide approach to 89 gastroenterologists/hepatologists.</p> <p>The estimated 10-year interval age-adjusted anti-HCV-seropositive population is 745, 109 (3.28%), with an anticipated HCV-viremic population of 554, 361. Of anti-HCV-seropositive subjects, 36.2% had disease awareness. Among those with awareness, 39.6% had accessibility. The recommendation/acceptance rate of antiviral therapy was 70.6%. The treatment rate was 10.1% and 13.7% for the anti-HCV-seropositive and HCV-viremic population, respectively. With an anticipated treatment success rate of 80% in Taiwan, 8.1% of the anti-HCV-seropositive and 10.9% of the HCV-viremic population achieved successful treatment. The major treatment barriers were fear of adverse effects (37%), major disorders (17.6%), ineligibility for insurance reimbursement (17.6%), and lack of therapy awareness (11.3%).</p> <p>Despite the high rates of treatment response and nationwide coverage of insurance reimbursement, there remains a large gap between clinical efficacy and community effectiveness in anti-HCV treatment in Taiwan. Increasing disease awareness/treatment accessibility and introducing new therapeutic strategies with high tolerability are warranted.</p> </sec> </abstract>