Abstract：
BACKGROUND:Approximately 233,898 individuals in the Veterans Affairs healthcare network are hepatitis C virus (HCV)-infected, making the Veterans Affairs the single largest provider of HCV care in the USA. Direct-acting antiviral treatment regimens for HCV offer high cure rates. However, these medications pose an enormous financial burden, and whether HCV cure is associated with decreased healthcare costs is poorly defined. AIMS:To measure downstream healthcare costs in a national population of HCV-infected patients up to 9 years post-HCV antiviral treatment, to compare downstream healthcare costs between cured and uncured patients, and to assess impact of cirrhosis status on cost differences. METHODS:This is a retrospective cohort study (2004-2014) of hepatitis C-infected patients who initiated antiviral treatment within the United States Veterans Affairs healthcare system October 2004-September 2013. We measured inpatient, outpatient, and pharmacy costs after HCV treatment. RESULTS:For the entire cohort, cure was associated with mean cumulative cost savings in post-treatment years three-six, but no cost savings by post-treatment year nine. By post-treatment year nine, cure in cirrhosis patients was associated with a mean cumulative cost savings of $9474 (- 32,666 to 51,614) per patient, while cure in non-cirrhotic patients was associated with a mean cumulative cost excess of $2526 (- 12,211 to 7159) per patient. CONCLUSIONS:Among patients with cirrhosis at baseline, cure is associated with absolute cost savings up to 9 years post-treatment compared to those without cure. Among patients without cirrhosis, early post-treatment cost savings are counterbalanced by higher costs in later years.
journal_name
Dig Dis Scijournal_title
Digestive diseases and sciencesauthors
Maier MM,Zhou XH,Chapko M,Leipertz SL,Wang X,Beste LAdoi
10.1007/s10620-018-4956-0subject
Has Abstractpub_date
2018-06-01 00:00:00pages
1454-1462issue
6eissn
0163-2116issn
1573-2568pii
10.1007/s10620-018-4956-0journal_volume
63pub_type
杂志文章abstract：BACKGROUND:Amoxicillin, metronidazole, proton pump inhibitor, bismuth quadruple therapy had been shown to reliably achieve high eradication rates. The role of individual components remains undefined. AIM:To identify the additional benefit/role of bismuth in amoxicillin, metronidazole, proton pump inhibitor, bismuth qu...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/s10620-020-06115-7
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abstract：BACKGROUND AND AIM:Aberrant methylation of specific genes is frequent event in hepatocellular carcinoma (HCC). Our present study aims to explore the methylation levels of acid phosphatase locus 1 (ACP1), bone morphogenetic protein 4 (BMP4), and testis-specific protein, Y-encoded-like 5 (TSPYL5) and their potential clin...
journal_title：Digestive diseases and sciences
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abstract：BACKGROUND:A role of an altered dietary pattern (e.g., a diet rich in sugar) but also alterations at the level of the intestinal barrier have repeatedly been discussed to be involved in the development and progression of nonalcoholic fatty liver disease (NAFLD). AIMS:To determine if the nutritional intake, intestinal ...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/s10620-012-2112-9
更新日期：2012-07-01 00:00:00
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journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/s10620-020-06056-1
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journal_title：Digestive diseases and sciences
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doi：10.1007/s10620-008-0516-3
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journal_title：Digestive diseases and sciences
pub_type： 临床试验,杂志文章,随机对照试验
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abstract：:Ascites is more difficult to detect when only a small quantity is present. The aim of this pilot study was to determine the optimal bowel sound characteristics in order to distinguish no ascites from small-volume ascites by advanced processing of bowel sound wave patterns. This analysis results in the definition of th...
journal_title：Digestive diseases and sciences
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doi：10.1023/a:1024788428692
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abstract：:A patient with congenital asucrasia was investigated using in vivo differential urinary disaccharide excretion. Impaired hydrolysis of sucrose and isomaltose, but normal lactase activity, were demonstrated and confirmed by in vitro estimation. The technique of differential disaccharide excretion can now be used to ass...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/BF01536167
更新日期：1989-01-01 00:00:00
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journal_title：Digestive diseases and sciences
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doi：10.1023/a:1005636412287
更新日期：2001-02-01 00:00:00
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journal_title：Digestive diseases and sciences
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journal_title：Digestive diseases and sciences
pub_type： 临床试验,杂志文章
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更新日期：2008-04-01 00:00:00
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journal_title：Digestive diseases and sciences
pub_type： 临床试验,杂志文章,随机对照试验
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更新日期：2002-08-01 00:00:00
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journal_title：Digestive diseases and sciences
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doi：10.1007/s10620-009-0837-x
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journal_title：Digestive diseases and sciences
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doi：10.1007/BF01297196
更新日期：1987-09-01 00:00:00
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journal_title：Digestive diseases and sciences
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doi：10.1007/BF01324950
更新日期：1983-04-01 00:00:00
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journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/s10620-011-1689-8
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journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/s10620-012-2242-0
更新日期：2012-11-01 00:00:00
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journal_title：Digestive diseases and sciences
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doi：10.1023/a:1026655311878
更新日期：1998-12-01 00:00:00
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journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/BF01307980
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journal_title：Digestive diseases and sciences
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journal_title：Digestive diseases and sciences
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journal_title：Digestive diseases and sciences
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journal_title：Digestive diseases and sciences
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journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/BF01535751
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journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1023/a:1022828507557
更新日期：2003-04-01 00:00:00
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journal_title：Digestive diseases and sciences
pub_type： 杂志文章
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journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/s10620-009-0934-x
更新日期：2010-02-01 00:00:00
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journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/BF01308373
更新日期：1981-04-01 00:00:00
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journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/s10620-015-3536-9
更新日期：2015-06-01 00:00:00
