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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 7 of 7 Research Studies DisplayedAuty SG, Griffith KN, Shafer PR
Improving access to high-value, high-cost medicines: the use of subscription models to treat hepatitis C using direct acting antivirals in the United States.
This paper discusses the use of state-sponsored subscription models to support increased access to high-value medications such as direct acting antivirals (DAAs) which can cure chronic Hepatitis C virus (HCV). The authors discuss the use of subscription models, a type of advanced purchase commitment (APC), to support increased access to high-value DAAs to treat HCV. They provide background information on HCV, its treatment, and state financing of prescription medications. They review the implementation of HCV subscription models in two states, Louisiana and Washington, and early evidence of their impact, as DAAs can cost upwards of $90,000 for treatment course.
AHRQ-funded; HS026395.
Citation: Auty SG, Griffith KN, Shafer PR .
Improving access to high-value, high-cost medicines: the use of subscription models to treat hepatitis C using direct acting antivirals in the United States.
J Health Polit Policy Law 2022 Dec 1;47(6):691-708. doi: 10.1215/03616878-10041121..
Keywords: Hepatitis, Medication, Chronic Conditions, Access to Care
Clements KM, Kunte PS, Clark MA
Uptake of hepatitis C virus treatment in a multi-state Medicaid population, 2013-2017.
The purpose of this study was to explore trends in the direct acting antiviral (DAA) uptake in a multi-state Medicaid population with hepatitis C virus (HCV) prior to and after ledipasvir/sofosbuvir (LDV/SOF) approval and changes in prior authorization (PA) requirements. The researchers analyzed annual enrollment, medical, and pharmacy claims for 38,302 to 45,005 people per year in four states, between December 2013 and December 2017. The study found that uptake increased from 0.34% per month in October 2014 to 0.70% per month after LDV/SOF approval and increased relative to the pre-LDV/SOV trend through June 2016. Uptake increased to 1.18% per month after PA change and remained static through 2017. In plans with few or no requirements through 2017, uptake increased to 1.19% per month after LDV/SOF approval and remained static through 2017, with 22.2% cumulatively treated. Among plans that lifted PA requirements from three to zero in mid-2016, uptake did not increase after LDV/SOF approval but did increase to 1.41% per month after PA change, with 18.1% cumulatively treated. The researchers concluded that LDV/SOF approval and lifting PA requirements led to an increase in uptake followed by static monthly utilization, and HCV treatment increased through 2017.
AHRQ-funded; HS025717.
Citation: Clements KM, Kunte PS, Clark MA .
Uptake of hepatitis C virus treatment in a multi-state Medicaid population, 2013-2017.
Health Serv Res 2022 Dec;57(6):1312-20. doi: 10.1111/1475-6773.13994..
Keywords: Hepatitis, Medicaid, Infectious Diseases, Healthcare Utilization
Lo Re VR, Zeldow B, Kallan MJ
Risk of liver decompensation with cumulative use of mitochondrial toxic nucleoside analogues in HIV/hepatitis C virus coinfection.
This cohort study was conducted to determine if cumulative mitochondrial toxic nucleoside reverse transcriptase inhibitors (mtNRTI) use increased the risk of hepatic decompensation and death among patients coinfected with human immunodeficiency virus (HIV) and chronic hepatitis C virus (HCV). The findings suggest that cumulative mtNRTI use may increase the risk of hepatic decompensation and death in HIV/HCV coinfection and should be avoided when alternatives exist for HIV/HCV patients.
AHRQ-funded; HS018372.
Citation: Lo Re VR, Zeldow B, Kallan MJ .
Risk of liver decompensation with cumulative use of mitochondrial toxic nucleoside analogues in HIV/hepatitis C virus coinfection.
Pharmacoepidemiol Drug Saf 2017 Oct;26(10):1172-81. doi: 10.1002/pds.4258..
Keywords: Adverse Drug Events (ADE), Hepatitis, Human Immunodeficiency Virus (HIV), Medication, Patient Safety
McMahon BJ, Bruden D, Townsend-Bulson L
Infection with hepatitis C virus genotype 3 is an independent risk factor for end-stage liver disease, hepatocellular carcinoma, and liver-related death.
The researchers examined the association of 11 risk factors with adverse outcomes in a population-based prospective cohort observational study of Alaska Native/American Indian persons with chronic infection. They found those infected with HCV genotype 3 to be at high risk for end-stage liver disease, hepatocellular carcinoma, and liver-related death.
AHRQ-funded; HS000046.
Citation: McMahon BJ, Bruden D, Townsend-Bulson L .
Infection with hepatitis C virus genotype 3 is an independent risk factor for end-stage liver disease, hepatocellular carcinoma, and liver-related death.
Clin Gastroenterol Hepatol 2017 Mar;15(3):431-37.e2. doi: 10.1016/j.cgh.2016.10.012.
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Keywords: Hepatitis, Cancer, Kidney Disease and Health, Risk, Mortality
Schmajuk G, Tonner C, Trupin L
Using health-system-wide data to understand hepatitis B virus prophylaxis and reactivation outcomes in patients receiving rituximab.
Hepatitis B virus (HBV) reactivation in the setting of rituximab use is a potentially fatal but preventable safety event. The rate of HBV screening and proportion of patients at risk who receive antiviral prophylaxis in patients initiating rituximab is unknown. This study found wide variations in hepatitis B screening practices among patients receiving rituximab, resulting in unnecessary risks to patients.
AHRQ-funded; HS023558; HS024412.
Citation: Schmajuk G, Tonner C, Trupin L .
Using health-system-wide data to understand hepatitis B virus prophylaxis and reactivation outcomes in patients receiving rituximab.
Medicine 2017 Mar;96(13):e6528. doi: 10.1097/md.0000000000006528.
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Keywords: Hepatitis, Electronic Health Records (EHRs), Medication, Prevention, Patient Safety
Linas BP, Morgan JR, Pho MT
Cost effectiveness and cost containment in the era of interferon-free therapies to treat hepatitis c virus genotype 1.
This study used Monte Carlo simulation to investigate budgetary impact and cost effectiveness of treatment policies for interferon-free regimens to treat hepatitis C virus (HCV) genotype 1 and to identify strategies that balance access with cost control. It found that among noncirrhotic patients, using the least costly interferon-free regimen, even if it is not single tablet or once daily, is the cost-control strategy that results in best outcomes.
AHRQ-funded; HS022433.
Citation: Linas BP, Morgan JR, Pho MT .
Cost effectiveness and cost containment in the era of interferon-free therapies to treat hepatitis c virus genotype 1.
Open Forum Infect Dis 2017 Winter;4(1):ofw266. doi: 10.1093/ofid/ofw266.
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Keywords: Hepatitis, Healthcare Costs, Healthcare Costs, Treatments
Saeed MJ, Olsen MA, Powderly WG
Diabetes mellitus is associated with higher risk of developing decompensated cirrhosis in chronic hepatitis C patients.
This study investigated the association of diabetes with risk of decompensated cirrhosis in patients with chronic hepatitis C (CHC). In a privately insured US population with CHC, the rates of decompensated cirrhosis per 1000 person-years were: 185.5 for persons with baseline cirrhosis and diabetes, 119.8 for persons with cirrhosis and no diabetes, 35.3 for persons with no cirrhosis and diabetes, and 17.1 for persons with no cirrhosis and no diabetes.
AHRQ-funded; HS019455.
Citation: Saeed MJ, Olsen MA, Powderly WG .
Diabetes mellitus is associated with higher risk of developing decompensated cirrhosis in chronic hepatitis C patients.
J Clin Gastroenterol 2017 Jan;51(1):70-76. doi: 10.1097/mcg.0000000000000566.
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Keywords: Chronic Conditions, Diabetes, Hepatitis, Risk