Interesting study from the Medco folks, published in the American Journal of Managed Care and presented recently at the 2011 International Conference on Viral Hepatitis. Medco used de-personalized data from their drug claims database to look at 3,607 patients newly Rx'd Peg-interferon and ribavirin for treatment of HCV. They evaluated adherence using a ratio called the 'medication possession ratio' or MPR, which measures the percent of time that HCV patients had medication available for their use. Patients with a MPR that was equal or greater than 80% were considered adherent. The study found that among patients with HCV who were both on HCV therapy and using an antidepressant, 68.5 percent were adherent. Grant it, database studies - like any study - comes with it's own inherent biases and it's hard to gather what other extraneous variables might have had impact on adherence, such as support groups, family support system, physician or mid-level check-ins, etc. Still, pretty impactful and compelling data that makes sense - if you feel better, one can assume that you'd feel more compelled to take one's medication.
BALTIMORE, April 11, 2011 /PRNewswire/ -- Adherence to interferon, an important medication used to treat Hepatitis C, is critical to successfully clearing the virus that causes the disease. A new observational analysis by Medco Health Solutions, Inc. (NYSE: MHS) finds that when Hepatitis C patients are also being treated for depression -- a frequent side effect of interferon use -- they are more likely to remain on their interferon therapy. The analysis is being presented today at the International Conference on Viral Hepatitis 2011.
According to the study, approximately 40 percent of Hepatitis C patients on interferon and ribavirin -- an antiviral medication used in combination with interferon -- were not adherent to their medication regimen. This puts patients at risk for progression of their disease due to their inability to eliminate the virus. The research found that the patients also using an antidepressant had the highest rates of adherence to their Hepatitis C treatment. Among patients with Hepatitis C who were using an antidepressant, 68.5 percent were adherent to their interferon therapy. For patients being treated for both Hepatitis C and HIV, 77.3 percent taking antidepressants were properly complying with their interferon therapy. Overall, 46 percent of patients with Hepatitis C were on an antidepressant.
"A common side-effect of interferon is depression, but little research has been done looking at the impact of treating depression on a patient's adherence with their Hepatitis C medications," said Mary Cassler RPh, Director of Clinical Innovation in Medco's Advanced Clinical Science and Research Group, who conducted the analysis. "These findings point to the need to proactively screen patients on interferon for depression and make sure that those who show signs of depression receive the proper interventions."
The usual course of interferon therapy for patients with Hepatitis C lasts either 24 or 48 weeks depending on the genotype of the virus, which influences the duration of treatment. Patients who discontinue use of the medication before treatment is completed, or those who do not take their medication as prescribed, frequently need to be retreated. Patients who fail to completely eliminate the virus have a higher risk of developing liver cancer. According to a study published in the American Journal of Managed Care, therapy can cost more than $40,000 per patient.
"Depression, whether interferon-induced or a separate co-morbid condition, can sabotage efforts to effectively treat Hepatitis C," said Dr. David Muzina, National Practice Leader, Medco Neuroscience Therapeutic Resource Center®. "All health care professionals, including pharmacists, need to know how to detect depression and work together to support safe, effective and affordable treatments."
Details
The analysis reviewed de-identified prescription drug claims from Medco's database and identified 3,607 patients who were newly prescribed interferon and ribavirin to treat Hepatitis C. Among the Hepatitis C patients who were identified, only 1,657 were being treated for depression. For the 109 patients who were also co-infected with HIV, 66 were on an antidepressant.
Adherence was evaluated by using the medication possession ratio (MPR) which measures the percent of time that patients have medication available for their use. Patients whose MPR was 80 percent or greater were considered adherent.
Added Richard Faris, PhD, RPh, National Practice Leader of the Accredo Rare and Specialty Pharmacy Therapeutic Resource Center: "These findings are important because they help in identifying patients experiencing depression while being treated in the home, and enable intervention to drive better outcomes for the patient and reduced costs for the payer."
About Medco
Medco Health Solutions, Inc. (NYSE: MHS) is pioneering the world's most advanced pharmacy® and its clinical research and innovations are part of Medco making medicine smarter™ for approximately 65 million members.
With more than 20,000 employees worldwide dedicated to improving patient health and reducing costs for a wide range of public and private sector clients, and 2010 revenues of nearly $66 billion, Medco ranks 35th on the Fortune 500 list and is named among the world's most innovative, most admired and most trustworthy companies.
For more information, go to http://www.medcohealth.com.
This press release contains "forward-looking statements" as that term is defined in the Private Securities Litigation Reform Act of 1995. These statements involve risks and uncertainties that may cause results to differ materially from those set forth in the statements. No forward-looking statement can be guaranteed, and actual results may differ materially from those projected. We undertake no obligation to publicly update any forward-looking statement, whether as a result of new information, future events, or otherwise. Forward-looking statements in this press release should be evaluated together with the risks and uncertainties that affect our business, particularly those mentioned in the Risk Factors section of the Company's Annual Report on Form 10-K and Quarterly Reports on Form 10-Q filed with the Securities and Exchange Commission.
SOURCE Medco Health Solutions, Inc.
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