Background Although hepatitis B (HB) drugs have strong antiviral activity, they cannot eradicate the virus, so they must be administered for long periods of time, making long-term adherence difficult to maintain. Non-adherent patients are more likely to have virologic failure, so it is necessary to promote an optimal adherence to treatments.
Purpose To describe the evolution of HB treatment management from a regional perspective, and to step beyond health outcomes (effectiveness and adherence) using integrated patient-centred computer tools.
Material and methods Descriptive study of the information obtained by the indicators that hospital pharmacies submit to the Regional Pharmacy Department every 3 months. These are indicators of the most relevant pathologies, including HB. Variables collected: since 2010 the total cost of antiviral treatment, number of average dispensed patients and cost per average dispensed patient/year; and since 2015, the percentage of patients with treatment and virological response (viral DNA <20 IU/ml) and the percentage of patients with treatment and adherence ≥90% (records of dispensing).
Results From 2010 to 2016, HB treatment expenditure has decreased by 35%. Patients with HB treatment have increased by 89% (1,594 patients in 2010 and 3019 in 2016). The cost per average dispensed patient has been 18% lower in 2016 than in 2010 (€3728 in 2010 and €3064 in 2016).
In 2015, the percentage of patients with virological response was 89.9% (range: 71%–98.7%) and this increased to 91.6% (range: 72%–100%) in 2016, which means an improvement of 1.8 percentage points. The percentage of patients with adherence ≥90% was 93.5% (range: 84.6%–100%) and decreased to 93.2% (range: 82.8%–100%) to next year, decreasing by 0.3 percentage points.
Conclusion The cost per patient has been reduced without decreasing the effectiveness, at least in the last years, with 91% of patients with virological response and 93% adherence.
Making progress in getting results in effectiveness and adherence adds value to merely economic indicators and allows clinical professionals useful tools for the management of therapeutic resources.
References and/or Acknowledgements Hospital Pharmacy Indicators Working Group.
No conflict of interest
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