Cargando…

Rapid and large-scale implementation of HCV treatment advances in France, 2007–2015

BACKGROUND: The last decade was marked by major advances in HCV treatment with the introduction of first wave protease inhibitors (1st-wave PIs, telaprevir or boceprevir) in 2011 and second direct-acting antivirals (2nd-wave DAAs) in 2014, that followed low effective pegylated interferon α / ribavir...

Descripción completa

Detalles Bibliográficos
Autores principales: Brouard, Cécile, Boussac-Zarebska, Marjorie, Silvain, Christine, Durand, Julien, de Lédinghen, Victor, Pillonel, Josiane, Delarocque-Astagneau, Elisabeth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5738822/
https://www.ncbi.nlm.nih.gov/pubmed/29262788
http://dx.doi.org/10.1186/s12879-017-2889-4
_version_ 1783287767716855808
author Brouard, Cécile
Boussac-Zarebska, Marjorie
Silvain, Christine
Durand, Julien
de Lédinghen, Victor
Pillonel, Josiane
Delarocque-Astagneau, Elisabeth
author_facet Brouard, Cécile
Boussac-Zarebska, Marjorie
Silvain, Christine
Durand, Julien
de Lédinghen, Victor
Pillonel, Josiane
Delarocque-Astagneau, Elisabeth
author_sort Brouard, Cécile
collection PubMed
description BACKGROUND: The last decade was marked by major advances in HCV treatment with the introduction of first wave protease inhibitors (1st-wave PIs, telaprevir or boceprevir) in 2011 and second direct-acting antivirals (2nd-wave DAAs) in 2014, that followed low effective pegylated interferon α / ribavirin bitherapy. We estimated the number of patients initiating HCV treatment in France between 2007 and 2015 according to the type of therapy, described their demographical characteristics, and estimated how many were cured with 2nd-wave DAAs in 2014–2015. METHODS: Individual data from the national health insurance information system were analysed. HCV treatment initiation was defined as a drug reimbursement in the absence of any reimbursement for the same drug in the previous six weeks. RESULTS: Between 2007 and 2015, 72,277 patients initiated at least one HCV treatment. The annual number of patients initiating treatment decreased from 2007 (~13,300) to 2010 (~10,000). It then increased with the introduction of 1st-wave PIs (~12,500 in 2012), before decreasing again in 2013 (~8400). A marked increase followed upon the approval of 2nd-wave DAAs in 2014 (~11,600). Approximately, 8700 and 14,700 patients initiated 2nd-wave DAAs in 2014 and 2015, respectively, corresponding to an estimated 20,300 cured patients in 2014–2015. Patients initiating HCV treatment were mostly male (~65% throughout the 9-year period). Women were older than men (mean age: 55.0 vs. 48.9). Increasing age was associated with more advanced treatment. Among patients initiating 2nd-wave DAAs, the proportions of those under 40 and over 79 years old increased between 2014 and 2015, whereas the proportion of those previously treated for HCV 2007 onwards declined. CONCLUSIONS: Successive advances in HCV treatment have been rapidly and widely implemented in France. With the announcement of universal access to DAAs in mid-2016 and price reductions, access to 2nd-wave DAAs is expected to expand even more.
format Online
Article
Text
id pubmed-5738822
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-57388222018-01-02 Rapid and large-scale implementation of HCV treatment advances in France, 2007–2015 Brouard, Cécile Boussac-Zarebska, Marjorie Silvain, Christine Durand, Julien de Lédinghen, Victor Pillonel, Josiane Delarocque-Astagneau, Elisabeth BMC Infect Dis Research Article BACKGROUND: The last decade was marked by major advances in HCV treatment with the introduction of first wave protease inhibitors (1st-wave PIs, telaprevir or boceprevir) in 2011 and second direct-acting antivirals (2nd-wave DAAs) in 2014, that followed low effective pegylated interferon α / ribavirin bitherapy. We estimated the number of patients initiating HCV treatment in France between 2007 and 2015 according to the type of therapy, described their demographical characteristics, and estimated how many were cured with 2nd-wave DAAs in 2014–2015. METHODS: Individual data from the national health insurance information system were analysed. HCV treatment initiation was defined as a drug reimbursement in the absence of any reimbursement for the same drug in the previous six weeks. RESULTS: Between 2007 and 2015, 72,277 patients initiated at least one HCV treatment. The annual number of patients initiating treatment decreased from 2007 (~13,300) to 2010 (~10,000). It then increased with the introduction of 1st-wave PIs (~12,500 in 2012), before decreasing again in 2013 (~8400). A marked increase followed upon the approval of 2nd-wave DAAs in 2014 (~11,600). Approximately, 8700 and 14,700 patients initiated 2nd-wave DAAs in 2014 and 2015, respectively, corresponding to an estimated 20,300 cured patients in 2014–2015. Patients initiating HCV treatment were mostly male (~65% throughout the 9-year period). Women were older than men (mean age: 55.0 vs. 48.9). Increasing age was associated with more advanced treatment. Among patients initiating 2nd-wave DAAs, the proportions of those under 40 and over 79 years old increased between 2014 and 2015, whereas the proportion of those previously treated for HCV 2007 onwards declined. CONCLUSIONS: Successive advances in HCV treatment have been rapidly and widely implemented in France. With the announcement of universal access to DAAs in mid-2016 and price reductions, access to 2nd-wave DAAs is expected to expand even more. BioMed Central 2017-12-20 /pmc/articles/PMC5738822/ /pubmed/29262788 http://dx.doi.org/10.1186/s12879-017-2889-4 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted 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. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Brouard, Cécile
Boussac-Zarebska, Marjorie
Silvain, Christine
Durand, Julien
de Lédinghen, Victor
Pillonel, Josiane
Delarocque-Astagneau, Elisabeth
Rapid and large-scale implementation of HCV treatment advances in France, 2007–2015
title Rapid and large-scale implementation of HCV treatment advances in France, 2007–2015
title_full Rapid and large-scale implementation of HCV treatment advances in France, 2007–2015
title_fullStr Rapid and large-scale implementation of HCV treatment advances in France, 2007–2015
title_full_unstemmed Rapid and large-scale implementation of HCV treatment advances in France, 2007–2015
title_short Rapid and large-scale implementation of HCV treatment advances in France, 2007–2015
title_sort rapid and large-scale implementation of hcv treatment advances in france, 2007–2015
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5738822/
https://www.ncbi.nlm.nih.gov/pubmed/29262788
http://dx.doi.org/10.1186/s12879-017-2889-4
work_keys_str_mv AT brouardcecile rapidandlargescaleimplementationofhcvtreatmentadvancesinfrance20072015
AT boussaczarebskamarjorie rapidandlargescaleimplementationofhcvtreatmentadvancesinfrance20072015
AT silvainchristine rapidandlargescaleimplementationofhcvtreatmentadvancesinfrance20072015
AT durandjulien rapidandlargescaleimplementationofhcvtreatmentadvancesinfrance20072015
AT deledinghenvictor rapidandlargescaleimplementationofhcvtreatmentadvancesinfrance20072015
AT pilloneljosiane rapidandlargescaleimplementationofhcvtreatmentadvancesinfrance20072015
AT delarocqueastagneauelisabeth rapidandlargescaleimplementationofhcvtreatmentadvancesinfrance20072015