Adherence, persistence, healthcare utilization, and cost benefits of guideline-recommended hepatitis B pharmacotherapy

Figures & data

Figure 1.  Sample selection and attrition.

Table 1.  Patient demographic and clinical characteristics at index date, by cohort.

Characteristic	RT (n = 825) n (%)	NRT (n = 916) n (%)	p-value	Entecavir (n = 609) n (%)	Tenofovir (n = 216) n (%)	p-value
Male gender	544 (65.94)	612 (66.81)	0.700	405 (66.50)	139 (64.35)	0.567
Location
Northeast	340 (41.21)	386 (42.14)	0.405	246 (40.39)	94 (43.52)	0.728
Midwest	65 (7.88)	88 (9.61)	51 (8.37)	14 (16.48)
South	301 (36.48)	305 (33.30)	222 (36.45)	79 (36.57)
West	119 (14.42)	137 (14.96)	90 (14.75)	29 (13.43)
Age
18–44	462 (56.00)	506 (55.24)	0.750	343 (56.32)	119 (55.09)	0.755
45–64	363 (44.00)	410 (44.76)	266 (43.68)	97 (44.91)
Mean (SD)	Mean (SD)	Mean (SD)	Mean (SD)	–
Age (continuous)	42.98 (10.57)	42.65 (10.73)	0.510	42.87 (10.46)	43.30 (10.89)	0.612
Quan-Charlson comorbidity score*	1.25 (1.04)	1.22 (1.20)	0.519	1.24 (0.99)	1.27 (1.17)	0.722
Follow-up (number of days)	508.50 (361.93) [median 400.00]	704.56 (482.53) [median 596.00]	<0.001	568.29 (373.78) [median 491.00]	339.95 (261.29) [median 280.00]	<0.001

*The Quan-Charlson comorbidity index contains 19 categories of comorbidity and their associated weights that provide an overall comorbidity score to reflect the cumulative increased likelihood of 1-year mortality37,38.

RT, recommended therapy; NRT, not recommended therapy.

Table 2.  Unadjusted follow-up pharmacotherapy adherence and persistence and healthcare utilization.

RT (n = 825)	NRT (n = 916)	p-value	Entecavir (n = 609)	Tenofovir (n = 216)	p-value
n (%)	n (%)	n (%)	n (%)
Index medication MPR ≥ 80%	443 (53.70)	334 (36.46)	<0.001	311 (51.07)	132 (61.11)	0.011
Mean (SD)	Mean (SD)	Mean (SD)	Mean (SD)
Continuous index medication MPR	0.65 (0.37)	0.52 (0.37)	<0.001	0.63 (0.37)	0.71 (0.35)	0.007
Index medication persistence	281.97 (343.40)	292.23 (342.25)	0.533	316.89 (340.77)	183.53 (332.22)	<0.001
Monthly count of inpatient admissions	0.006 (0.054)	0.011 (0.060)	0.101	0.007 (0.061)	0.005 (0.028)	0.459
Monthly count of emergency room visits	0.031 (0.227)	0.038 (0.205)	0.526	0.037 (0.262)	0.015 (0.054)	0.051
Monthly count of ambulatory visits	1.031 (1.178)	1.088 (1.190)	0.310	1.025 (1.186)	1.046 (1.157)	0.820

Table 3.  Unadjusted follow-up healthcare costs.

Healthcare costs (PPPM)	RT (n = 825)	NRT (n = 916)	p-value	Entecavir (n = 609)	Tenofovir (n = 216)	p-value
Mean (SD)	Mean (SD)	Mean (SD)	Mean (SD)
Total costs	$1164 ($2425)	$1279 ($3791)	0.102	$1135 ($2248)	$1246 ($2870)	0.007
Pharmacy costs	$603 ($410)	$540 ($362)	<0.001	$625 ($436)	$539 ($320)	<0.001
Medical costs	$561 ($2315)	$739 ($3668)	0.082	$510 ($2136)	$706 ($2758)	0.428
Inpatient costs	$333 ($1189)	$397 ($1381)	0.293	$308 ($946)	$405 ($1698)	0.524
Emergency room costs	$7 ($29)	$8 ($52)	0.002	$6 ($25)	$8 ($37)	0.158
Ambulatory costs	$181 ($1668)	$302 ($3045)	<0.001	$166 ($1714)	$225 ($1534)	0.402
Other costs	$40 ($394)	$32 ($110)	<0.001	$30 ($131)	$69 ($739)	0.424

Table 4.  Summary of multivariate models*.

NRT (n = 916)	RT (n = 825)	Ratio or Estimated Coefficient (95% CI)^†	p-value
Adherence (MPR ≥ 80% vs <80%)	–	OR = 2.09	1.66–2.65	<0.001
Persistence (number of days)	298	361	63 (25–100)	0.001
Inpatient admissions	OR = 0.53	0.34–0.83	0.005
Total healthcare costs (PPPM)	$1332	$1214	0.91 (0.80–1.04)	0.156
	Entecavir (n = 609)	Tenofovir (n = 216)	Ratio or Estimated Coefficient (95% CI)^‡	p-value
Adherence (MPR ≥ 80% vs <80%)	–	OR = 1.17	0.81–1.71	0.402
Persistence (number of days)	356	303	−53 (−114–7)	0.085
Inpatient admissions	–	IRR = 1.12	0.48–2.64	0.790
Total healthcare costs (PPPM)	$1151	$1213	1.05 (0.88–1.26)	0.560

*Multivariate analyses controlled for age, gender, location, year of antiviral initiation, baseline healthcare utilization, and baseline comorbidity.

^†NRT group is the reference group.

^‡Entecavir group is the reference group.

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