Depression can sabotage efforts to effectively treat Hepatitis C

Apr 12 2011

Adherence to interferon, an important medication used to treat Hepatitis C, is critical to successfully clearing the virus that causes the disease. A new observational analysis by Medco Health Solutions, Inc. (NYSE: MHS)  finds that when Hepatitis C patients are also being treated for depression -- a frequent side effect of interferon use -- they are more likely to remain on their interferon therapy.  The analysis is being presented today at the International Conference on Viral Hepatitis 2011.

According to the study, approximately 40 percent of Hepatitis C patients on interferon and ribavirin -- an antiviral medication used in combination with interferon -- were not adherent to their medication regimen. This puts patients at risk for progression of their disease due to their inability to eliminate the virus. The research found that the patients also using an antidepressant had the highest rates of adherence to their Hepatitis C treatment. Among patients with Hepatitis C who were using an antidepressant, 68.5 percent were adherent to their interferon therapy.  For patients being treated for both Hepatitis C and HIV, 77.3 percent taking antidepressants were properly complying with their interferon therapy.  Overall, 46 percent of patients with Hepatitis C were on an antidepressant.

"A common side-effect of interferon is depression, but little research has been done looking at the impact of treating depression on a patient's adherence with their Hepatitis C medications," said Mary Cassler RPh, Director of Clinical Innovation in Medco's Advanced Clinical Science and Research Group, who conducted the analysis.  "These findings point to the need to proactively screen patients on interferon for depression and make sure that those who show signs of depression receive the proper interventions."

The usual course of interferon therapy for patients with Hepatitis C lasts either 24 or 48 weeks depending on the genotype of the virus, which influences the duration of treatment.  Patients who discontinue use of the medication before treatment is completed, or those who do not take their medication as prescribed, frequently need to be retreated.  Patients who fail to completely eliminate the virus have a higher risk of developing liver cancer.  According to a study published in the American Journal of Managed Care, therapy can cost more than $40,000 per patient.

"Depression, whether interferon-induced or a separate co-morbid condition, can sabotage efforts to effectively treat Hepatitis C," said Dr. David Muzina, National Practice Leader, Medco Neuroscience Therapeutic Resource Center®. "All health care professionals, including pharmacists, need to know how to detect depression and work together to support safe, effective and affordable treatments."