Semin Liver Dis 2007; 27: 26-31
DOI: 10.1055/s-2007-984572
Copyright © 2007 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Economic Impact of Treatment Options for Hepatic Encephalopathy

Carroll B. Leevy1
  • 1New Jersey Medical School Liver Center, Newark, New Jersey
Further Information

Publication History

Publication Date:
14 August 2007 (online)

ABSTRACT

Complications of chronic liver disease, such as hepatic encephalopathy (HE), can have a substantial impact on the economic burden of liver disease. In the United States, a report of 162,734 inpatient hospital discharges included HE or unspecified encephalopathy diagnoses in 2004, a 234% increase over data from 1993. Hospital charges for HE and HE-related conditions also increased from 1993 to 2004 in the United States. Mean hospital charges have increased despite a steady reduction in the mean duration of stay, a trend that may reflect advances in treatment. Several studies have provided data about the cost-effectiveness of rifaximin and lactulose as treatments for HE. These studies showed that, although rifaximin costs more per tablet than lactulose, rifaximin is more cost-effective for long-term therapy. Further studies are warranted to more fully evaluate the relative long-term cost-effectiveness of specific HE treatments.

REFERENCES

  • 1 American Gastroenterological Association .The Burden of Gastrointestinal Diseases. Chapter 5: Hepatobiliary and pancreatic disorders. http://Available at: www.gastro.org/user-assets/Documents/burden-report.pdf Accessed January 5, 2007
  • 2 Mas A. Hepatic encephalopathy: from pathophysiology to treatment.  Digestion. 2006;  73(suppl 1) 86-93
  • 3 Abou-Assi S, Vlahcevic Z R. Hepatic encephalopathy: metabolic consequence of cirrhosis often is reversible.  Postgrad Med. 2001;  109 52-60, 63
  • 4 Amodio P, Del Piccolo F, Petteno E et al.. Prevalence and prognostic value of quantified electroencephalogram (EEG) alterations in cirrhotic patients.  J Hepatol. 2001;  35 37-45
  • 5 Romero-Gomez M, Boza F, Garcia-Valdecasas M S et al.. Subclinical hepatic encephalopathy predicts the development of overt hepatic encephalopathy.  Am J Gastroenterol. 2001;  96 2718-2723
  • 6 Ytting H, Moller S, Henriksen J H et al.. Prognosis in patients with cirrhosis and mild portal hypertension.  Scand J Gastroenterol. 2006;  41 1446-1453
  • 7 Hartmann I J, Groeneweg M, Quero J C et al.. The prognostic significance of subclinical hepatic encephalopathy.  Am J Gastroenterol. 2000;  95 2029-2034
  • 8 Kircheis G, Wettstein M, Timmermann L et al.. Critical flicker frequency for quantification of low-grade hepatic encephalopathy.  Hepatology. 2002;  35 357-366
  • 9 Groeneweg M, Quero J C, De Bruijn I et al.. Subclinical hepatic encephalopathy impairs daily functioning.  Hepatology. 1998;  28 45-49
  • 10 Das A, Dhiman R K, Saraswat V A et al.. Prevalence and natural history of subclinical hepatic encephalopathy in cirrhosis.  J Gastroenterol Hepatol. 2001;  16 531-535
  • 11 Han M K, Hyzy R. Advances in critical care management of hepatic failure and insufficiency.  Crit Care Med. 2006;  34 S225-S231
  • 12 Agency for Healthcare Research Quality .HCUPnet: Healthcare Cost and Utilization Project. Available at: http://hcupnet.ahrq.gov/HCUPnet.jsp?Id=DBE1CCF502E0C25D&Form=SelQUERYTYPE&JS=Y&Action=%3E%3ENext%3E%3E&_QUERYTYPE=Trends Accessed February 2007
  • 13 Shaheen N J, Hansen R A, Morgan D R et al.. The burden of gastrointestinal and liver diseases, 2006.  Am J Gastroenterol. 2006;  101 2128-2138
  • 14 Wong J B, McQuillan G M, McHutchison J G, Poynard T. Estimating future hepatitis C morbidity, mortality, and costs in the United States.  Am J Public Health. 2000;  90 1562-1569
  • 15 Koo H L, DuPont H L. Current and future developments in travelers' diarrhea therapy.  Expert Rev Anti Infect Ther. 2006;  4 417-427
  • 16 Scarpignato C, Pelosini I. Experimental and clinical pharmacology of rifaximin, a gastrointestinal selective antibiotic.  Digestion. 2006;  73(suppl 1) 13-27
  • 17 Neff G W, Kemmer N, Zacharias V C et al.. Analysis of hospitalizations comparing rifaximin versus lactulose in the management of hepatic encephalopathy.  Transplant Proc. 2006;  38 3552-3555
  • 18 Spiegel B, Huang E, Esrailian E. Is rifaximin cost-effective in the management of hepatic encephalopathy?.  Gastroenterology. 2006;  130 A-806
  • 19 Leevy C B, Phillips J A. Hospitalizations during the use of rifaximin versus lactulose for the treatment of hepatic encephalopathy.  Dig Dis Sci. 2007;  52 737-741

Carroll B LeevyM.D. 

New Jersey Medical School Liver Center

90 Bergen Street, Suite 2100, Newark, NJ 07103

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