Epidemiology and Database Research, Maccabi Healthcare Services, Tel Aviv, Israel.
Health Economics and Outcomes Research, AbbVie, North Chicago, USA.
Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, USA.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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.