The impact on hospital resource utilisation of treatment of hepatic encephalopathy with rifaximin-α

James G. Orr, Craig J. Currie, Ellen Berni, Anurag Goel, Kieran J. Moriarty, Ashish Sinha, Fiona Gordon, Anne Dethier, John Dillon, Katie Clark, Paul Richardson, Paul Middleton, Vishal Patel, Debbie Shawcross, Helen Preedy, Richard J. Aspinall, Mark Hudson (Lead / Corresponding author)

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Background & Aims: Rifaximin-α reduces the risk of recurrence of overt hepatic encephalopathy. However, there remain concerns regarding the financial cost of the drug. We aimed to study the impact of treatment with rifaximin-α on healthcare resource utilisation using data from seven United Kingdom liver treatment centres.

Methods: All seven centres agreed a standardised data set and data characterising clinical, demographic and emergency hospital admissions were collected retrospectively for the time-periods three, six and 12 months before and following initiation of rifaximin-α. Admission rates and hospital length of stay before and during therapy were compared. Costs of admissions and drug acquisition were estimated using published sources. Multivariate analyses were carried out to assess the relative impact of various factors on hospital length of stay.

Results: Data were available from 326 patients. Following the commencement of rifaximin, the total hospital length of stay reduced by an estimated 31-53%, equating to a reduction in inpatient costs of between £4,858 and £6,607 per year. Taking into account drug costs of £3,379 for one year's treatment with rifaximin-α, there was an estimated annual mean saving of £1,480-£3,228 per patient.

Conclusions: Initiation of treatment with rifaximin-α was associated with a marked reduction in the number of hospital admissions and hospital length of stay. These data suggest that treatment of patients with rifaximin-α for hepatic encephalopathy was generally cost saving. This article is protected by copyright. All rights reserved.

Original languageEnglish
Pages (from-to)1295-1303
Number of pages9
JournalLiver International
Issue number9
Early online date5 Apr 2016
Publication statusPublished - Sept 2016


  • cirrhosis
  • health economics
  • hepatic encephalopathy
  • rifaximin-α


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