Dr Gail Bridges on the Importance of Real-World Results Matching Clinical Trial Outcomes

With the high cost of new drugs to cure hepatitis C, ensuring that real-world outcomes are consistent with those seen in clinical trials is important, explained Gail Bridges, PharmD, of Accredo Health. She explained that Accredo ensured patients adhered to hepatitis C drugs in order to get the best outcomes through a disease- and drug-specific education program.

What impact do you think drug-specific education had on patients taking Harvoni or Viekira Pak for hepatitis C? Is the model translatable to other disease states?
As we're all aware, adherence is challenging in the real world. In our experience I think it takes an array of support tools to really help patients succeed on these therapies. In our study patients received care from specialty pharmacists and nurses who focused solely on hepatitis C.

So they received drug- and disease-specific education, as well as access to technology support, such as the Accredo Plus C adherence app, videos, they received proactive adherence coaching throughout their therapy. So all of these things contributed to, I think, the results that we saw in this study [that cure rates in the real-world were similar to those in clinical trials for patients taking Viekira Pak and Harvoni for hepatitis C].

I don't think there's one solution for all patients, but I think having a robust toolkit of these support methodologies, if you will, is important, so taht each patient can find the right tool that works for them.

With the high cost of hepatitis C drugs, what is the importance of determining the real-world outcomes and the fact that they are similar to clinical trial results?
We all are stewards of our healthcare resources, right? So we all have a role to play in ensuring judicious use of those resources. And any time there's such a large increase in cost, as we saw with the advent of the direct-acting antiviral era, we have to examine those real-world outcomes and make sure that those benefits are commensurate to that cost increase.

Historically, we've struggled a little bit in hepatitis C to really achieve real-world results that are on point with those seenn in clinical trials. So I think that it's exciting to see that we have data now to show that our patients, taking these medications in the specialty model can achieve those types of results that are consistent with those seen in clinical trials.
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