Hepatitis C Virus Infection Treatment Completion: An Analysis of the Quebec Provincial Reimbursement Program Database


      Hepatitis C virus (HCV) infection treatment completion is a key success factor for achieving optimal clinical outcomes. The objective of this study was to assess HCV treatment completion rates in a real life setting.


      A retrospective study of the Quebec provincial drug reimbursement program (RAMQ) was conducted using a random sample of patients who filled at least one script at the pharmacy for an HCV medication (pegylated interferon and ribavirin (peg-Riba) +/- boceprevir or telaprevir) from January 2007 to December 2012. Treatment completion rates were calculated at week 12, 24 and 28 according to HCV medication type in order to assess the proportion of patients treated beyond the 12-week futility threshold and the minimal expected treatment duration of 24 weeks (28 weeks for Peg-Riba + boceprevir).


      A total of 1,081 patients who used at least one HCV medication were included in the study. The average age was 46.4 years (SD=10.7) and the proportion of men was higher (64.8%). During the study period, the number of patients who used Peg-Riba only, Peg-Riba + boceprevir and Peg-Riba + telaprevir was 1,029 (95.2%), 50 (4.6%) and 18 (1.7%) respectively. The proportion of patients on Peg-Riba only who completed at least 12 and 24 weeks of treatment was 89.7% and 62.2% respectively. There were 96.0% and 58.0% of patients on Peg-Riba + boceprevir who remained on treatment at week 12 and 28 respectively. The percentage of patients on Peg-Riba + telaprevir on treatment at week 12 and 24 was 50.0% and 11.1%, respectively.


      The proportion of HCV patients who were still on treatment decreased with time with high discontinuation rates especially after week 12. Treatment completion was not achieved by a significant proportion of patients, regardless of HCV medications.