Rapid and large-scale implementation of HCV treatment advances in France, 2007–2015
Abstract 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 /...
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doaj-7686877aa0934d5bbef2e42b95f41ae02020-11-25T03:45:19ZengBMCBMC Infectious Diseases1471-23342017-12-0117111210.1186/s12879-017-2889-4Rapid and large-scale implementation of HCV treatment advances in France, 2007–2015Cécile Brouard0Marjorie Boussac-Zarebska1Christine Silvain2Julien Durand3Victor de Lédinghen4Josiane Pillonel5Elisabeth Delarocque-Astagneau6Santé publique France, the national public health agencySanté publique France, the national public health agencyHepatology Unit, University HospitalSanté publique France, the national public health agencyInvestigation Centre of Liver Fibrosis, Haut-Lévêque Hospital, Bordeaux University HospitalSanté publique France, the national public health agencyINSERM 1181, Biostatistics, Biomathematics, Pharmacoepidemiology, and Infectious Diseases (B2PHI)Abstract 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.http://link.springer.com/article/10.1186/s12879-017-2889-4Hepatitis CTreatmentDirect-acting antiviralsHealth insurance dataEpidemiologyFrance |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Cécile Brouard Marjorie Boussac-Zarebska Christine Silvain Julien Durand Victor de Lédinghen Josiane Pillonel Elisabeth Delarocque-Astagneau |
spellingShingle |
Cécile Brouard Marjorie Boussac-Zarebska Christine Silvain Julien Durand Victor de Lédinghen Josiane Pillonel Elisabeth Delarocque-Astagneau Rapid and large-scale implementation of HCV treatment advances in France, 2007–2015 BMC Infectious Diseases Hepatitis C Treatment Direct-acting antivirals Health insurance data Epidemiology France |
author_facet |
Cécile Brouard Marjorie Boussac-Zarebska Christine Silvain Julien Durand Victor de Lédinghen Josiane Pillonel Elisabeth Delarocque-Astagneau |
author_sort |
Cécile Brouard |
title |
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_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_sort |
rapid and large-scale implementation of hcv treatment advances in france, 2007–2015 |
publisher |
BMC |
series |
BMC Infectious Diseases |
issn |
1471-2334 |
publishDate |
2017-12-01 |
description |
Abstract 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. |
topic |
Hepatitis C Treatment Direct-acting antivirals Health insurance data Epidemiology France |
url |
http://link.springer.com/article/10.1186/s12879-017-2889-4 |
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