Utilization and Antiviral Therapy in Patients with Chronic Hepatitis C: Analysis of Ambulatory Care Visits in the US

March 10, 2010

Dig Dis Sci. 2010 Feb 26. [Epub ahead of print]Utilization and Antiviral Therapy

in Patients with Chronic Hepatitis C: Analysis of Ambulatory Care Visits in the

US.Cheung R, Mannalithara A, Singh G.Division of Gastroenterology and

Hepatology, Stanford University, Stanford, CA, USA,

rcheung@...: Studies on mostly veterans found the majority

of chronic hepatitis C (CHC) patients were not treated. Little information

exists on a broad-based population. AIMS: To determine the national trend of

ambulatory visits with a diagnosis of hepatitis C and the prescription of

antiviral therapy associated with such visits. METHODS: Retrospective analysis

of national cross-sectional databases, the National Ambulatory Medical Care

Survey (NAMCS), and the National Hospital Ambulatory Medical Care Survey

(NHAMCS) encompassing all ambulatory visits from 2000 to 2006. RESULTS: During

the study period, 16.5 million visits (0.21% of all visits) carried a diagnosis

of hepatitis C and the number initially increased. Characteristics of the

hepatitis C patients were: 65% male; 71% white, 22% black; 69%>/=45 years old.

Overall, 47% had private insurance, 24% had Medicaid, and 12% had Medicare. Only

9.1% of these patients were prescribed antiviral treatment for CHC. There was no

significant difference between those who received treatment and those who did

not in terms of age, gender, race, and insurance status. HIV infection, mood,

substance-use disorders, and anemia were more common in the CHC group.

CONCLUSIONS: Less than 10% of the ambulatory visits for hepatitis C were

associated with a prescription for antiviral therapy, independent of demographic

and insurance status. Purposes of the clinic visits were different in the CHC

group compared to the general population. The reason for the low treatment rate

is not clear but deserves further investigation.PMID: 20186486 [PubMed - as

supplied by publisher]

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