BackgroundNew interferon (IFN)-free treatments for hepatitis C are more effective, safer but more expensive than current IFN-based therapies. Comparative data of these, versus current first generation protease inhibitors (PI) with regard to costs and treatment outcomes are needed. We investigated the real-world effectiveness, safety and cost per cure of 1st generation PI-based therapies in the UK.MethodsMedical records review of patients within the HCV Research UK database. Patients had received treatment with telaprevir or boceprevir and pegylated interferon and ribavirin (PR). Data on treatment outcome, healthcare utilisation and adverse events (AEs) requiring intervention were collected and analysed overall and by subgroups. Costs of visits, tests, therapies, adverse events and hospitalisations were estimated at the patient level. Total cost per cure was calculated as total median cost divided by SVR rate.Results154 patients from 35 centres were analysed. Overall median total cost per cure was £44,852 (subgroup range,: £35,492 to £107,288). Total treatment costs were accounted for by PI: 68.3 %, PR: 26.3 %, AE management: 5.4 %. Overall SVR was 62.3 % (range 25 % to 86.2 %). 36 % of patients experienced treatment-related AEs requiring intervention, 10 % required treatment-related hospitalisation.ConclusionsThis is the first UK multicentre study of outcomes and costs of PI-based HCV treatments in clinical practice. There was substantial variation in total cost per cure among patient subgroups and high rates of treatment-related discontinuations, AEs and hospitalisations. Real world safety, effectiveness and total cost per cure for the new IFN free combinations should be compared against this baseline.Electronic supplementary materialThe online version of this article (doi:10.1186/s41124-016-0002-z) contains supplementary material, which is available to authorized users.

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A 3 4 7 -A 7 6 6 A683 analysed, 53% were females; mean age was 57; mean diabetes duration was 9 years. Most had at least one HbA1c, blood lipid and blood pressure measure in the past year (87%, 93% and 86% respectively); 85% and 33% had GP and specialist visits in the past 3 months, respectively; 22% received diabetes education, 40% were screened for complications and 29% of patients treated with insulin were self-monitored. 16% of patients experienced a hospitalisation. Overall, 41% of patients were considered as "well-managed" and 16% as "controlled" for their diabetes. Well-managed patients were significantly more likely to control their diabetes (OR[95% CI]: 1.96[1.64; 2.35]) and had significantly less hospitalisations (0.67[0.55; 0.82]) than not well-managed patients. ConClusions: Our study suggests that good management practices are associated with a reduction in avoidable resource consumption as well as improved diabetes control. This suggests that following established clinical recommendations could ensure not only good outcomes but also beneficial resource allocation.

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