Hepatitis C: Understanding factors that influence the physicians' treatment decisions

Abstract

This study aimed to inform Hepatitis C (HCV) treatment by (1) better understanding the nexus of factors physicians consider when making HCV treatment decisions; (2) investigating the comparative influence and importance of specific factors and the trade-offs implicated in the decisionmaking process; and (3) examining how much thrombocytopenia impacts treatment decisions and how it impacts treatment. To meet this goal, we conducted five analyses, focusing on four European countries characterised by different approaches to healthcare organisation and financing, which alongside cultural differences may have potential implications for treatment pathways for patients with HCV infection. These were: France, Italy, Spain, and the United Kingdom. These analysis included: Review the academic literature and of relevant national and European guidelines;Conduct key informant interviews (KIIs) with national experts to contextualise the data from the literature review and further explore some emerging themes;Map the patient journey in the four countries to identify stages HCV patients pass through once they have entered the healthcare system and map, for each stage, potential points of departure from the typical journey;Design and conduct of Discrete Choice Experiments (DCEs) to quantitatively assess the importance of factors that influence treatment decisions;Conduct expert workshop to help build scenarios identifying challenges to HCV treatment.The five analyses build on one another, with the first three providing evidence that fed into the design of the DCEs and with the DCE results in turn serving as the key inputs into building the scenarios for the expert workshop.