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Treatment of Hepatitis C in Era of D...

Mehta, Darshan.

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Treatment of Hepatitis C in Era of Direct Acting Antivirals (DAAs): Selected Essays in Health Economics.

Record Type:	Electronic resources : Monograph/item
Title/Author:	Treatment of Hepatitis C in Era of Direct Acting Antivirals (DAAs): Selected Essays in Health Economics./
Author:	Mehta, Darshan.
Published:	Ann Arbor : ProQuest Dissertations & Theses, : 2018,
Description:	137 p.
Notes:	Source: Dissertations Abstracts International, Volume: 80-06, Section: A.
Contained By:	Dissertations Abstracts International80-06A.
Subject:	Economics. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=11016231

Treatment of Hepatitis C in Era of Direct Acting Antivirals (DAAs): Selected Essays in Health Economics.
Mehta, Darshan.

Treatment of Hepatitis C in Era of Direct Acting Antivirals (DAAs): Selected Essays in Health Economics. - Ann Arbor : ProQuest Dissertations & Theses, 2018 - 137 p.

Source: Dissertations Abstracts International, Volume: 80-06, Section: A.

Thesis (Ph.D.)--University of Southern California, 2018.

This item must not be sold to any third party vendors.

Evidence surrounding the extra-hepatic effects and health related quality of life (HRQoL) of IFN free DAA regimens does exist in the clinical trial data collected and maintained by individual companies. These data cover effects during treatment and post-treatment periods, but remains unpublished to date. The objectives of the first two papers of this dissertation were to use the RCT data available at Abbvie to pursue two research objectives: 1. Evaluate the effect of treating with 3D regimen on patient`s health related quality of life. The study will evaluate the following three sub objectives: a. The impact of 3D±RBV on patients in HRQoL scores relative to placebo while on treatment; b. Whether or not the long-term impact of 3D±RBV therapy on HRQoL differs across sub-genotypes 1a and 1b. c. The post-treatment persistence of any 3D±RBV effects on HRQoL beyond 12 weeks; 2. Evaluate the impact of treating with 3D regimen on cardiovascular, metabolic and renal extra hepatic manifestations both during treatment in a randomly assigned patient population relative to placebo and long term relative to baseline . The study will evaluate following sub-objectives: a. The impact of 3D±RBV on renal, cardiovascular and metabolic EHMs as measured by eGFR, fasting triglycerides and fasting glucose levels; b. The differential treatment impact by EHM disease severity as defined by respective baseline biomarker level. c. The persistency of any treatment impact on EHMs 52 weeks post-treatment. In the era of curative therapies, understanding the drivers of the care cascade becomes of prime importance in achieving WHO elimination goals. Thus, the third paper in the dissertation, addresses the following research questions, leveraging data from large national private payer in US. 1. What are the patient characteristics that impact the likelihood that a patient will be screened for HCV? 2. What are the patient characteristics associated with a positive screening test? What are the factors that predict a positive confirmation of a chronic HCV infection in patients with a positive screening test? 3. For patients with confirmed infection, who gets treated (i.e. linked to care) and when.Subjects--Topical Terms:

517137
Economics.

Treatment of Hepatitis C in Era of Direct Acting Antivirals (DAAs): Selected Essays in Health Economics.
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520 $a Evidence surrounding the extra-hepatic effects and health related quality of life (HRQoL) of IFN free DAA regimens does exist in the clinical trial data collected and maintained by individual companies. These data cover effects during treatment and post-treatment periods, but remains unpublished to date. The objectives of the first two papers of this dissertation were to use the RCT data available at Abbvie to pursue two research objectives: 1. Evaluate the effect of treating with 3D regimen on patient`s health related quality of life. The study will evaluate the following three sub objectives: a. The impact of 3D±RBV on patients in HRQoL scores relative to placebo while on treatment; b. Whether or not the long-term impact of 3D±RBV therapy on HRQoL differs across sub-genotypes 1a and 1b. c. The post-treatment persistence of any 3D±RBV effects on HRQoL beyond 12 weeks; 2. Evaluate the impact of treating with 3D regimen on cardiovascular, metabolic and renal extra hepatic manifestations both during treatment in a randomly assigned patient population relative to placebo and long term relative to baseline . The study will evaluate following sub-objectives: a. The impact of 3D±RBV on renal, cardiovascular and metabolic EHMs as measured by eGFR, fasting triglycerides and fasting glucose levels; b. The differential treatment impact by EHM disease severity as defined by respective baseline biomarker level. c. The persistency of any treatment impact on EHMs 52 weeks post-treatment. In the era of curative therapies, understanding the drivers of the care cascade becomes of prime importance in achieving WHO elimination goals. Thus, the third paper in the dissertation, addresses the following research questions, leveraging data from large national private payer in US. 1. What are the patient characteristics that impact the likelihood that a patient will be screened for HCV? 2. What are the patient characteristics associated with a positive screening test? What are the factors that predict a positive confirmation of a chronic HCV infection in patients with a positive screening test? 3. For patients with confirmed infection, who gets treated (i.e. linked to care) and when.
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