Minneapolis [US], August 25 : High expenditures for treating hepatic encephalopathy in people with end-stage liver disease were linked to worse patient adherence to therapy, according to research from the University of Minnesota Medical School and College of Pharmacy.
The findings of the study were recently published in Hepatology Communications.
The loss of brain function that occurs in persons with severe liver illness is known as hepatic encephalopathy. High morbidity and mortality rates are linked to the disorder. Rifaximin is a medication that is frequently used to treat hepatic encephalopathy, however, treatment adherence is still low.
“Our research demonstrates that the cost of rifaximin is too high in the United States. Individuals with scarred livers, who have a higher out-of-pocket cost, are more likely to not fill their prescription for their medication, which can result in falls, hospitalizations and other poor outcomes,” said Elizabeth Aby, MD, an assistant professor at the University of Minnesota Medical School and transplant hepatologist at M Health Fairview. “Clinicians and policymakers need to be aware of the impact that out-of-pocket costs have on patients’ medication adherence for rifaximin. Active measures must be taken to address this issue.”
The study included more than 6,800 patients with cirrhosis — a condition where the liver is scarred from long-term damage — and hepatic encephalopathy. The research team’s analysis found patients who are younger and have metastatic cancer or depression are less likely to take their medication.
The research team suggests clinicians screen patients for financial insecurity and the potentially harmful effect the high cost of treatment could have on the patient, as well as involving social workers and financial assistance early. Additionally, further steps are needed to lower the cost of the drug.
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