Rates of Tx Retention for Rifaximin Low Despite Benefits for Hepatic Encephalopathy

Lower treatment retention rates seen with 30-day, out-of-pocket costs ≥$150

By Lori Solomon HealthDay Reporter

FRIDAY, Sept. 1, 2023 (HealthDay News) — Rates of rifaximin treatment retention are low despite the known benefits of rifaximin use for breakthrough hepatic encephalopathy (HE), according to a study published in the August issue of Hepatology Communications.

Elizabeth S. Aby, M.D., from University of Minnesota in Minneapolis, and colleagues evaluated the impact of out-of-pocket (OOP) rifaximin cost on treatment retention among commercially insured patients in the United States. The analysis included 6,839 adult patients with cirrhosis and HE who began rifaximin treatment from 2011 through 2021.

The researchers found that treatment retention was low for all time periods: 42 percent at 180 days, 25 percent at 360 days, and 16 percent at 540 days. Thirty-day OOP costs of ≥$150 were associated with a lower likelihood of rifaximin retention at 180, 360, and 540 days (relative risks [RRs], 0.67, 0.62, and 0.60, respectively). Across all time periods, younger age also was associated with lower treatment retention. At 180 days, metastatic cancer and depression were associated with lower treatment retention (RRs, 0.70 and 0.87, respectively).

“Clinicians and policy makers need to be aware of the impact that out-of-pocket costs have on patients’ medication adherence for rifaximin,” Aby said in a statement. “Active measures must be taken to address this issue.”

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