31 October 2016


– Data show that hospitals may require significantly less resource use if rifaximin-α is used1

LONDON, UK, Monday 31 October 2016, 15:00 GMT. Norgine B.V. today presented new UK real world data, IMPRESS, that show rifaximin-α for the treatment of hepatic encephalopathy could reduce costs related to non-elective hospital admissions, critical care bed occupancy, emergency room visits and 30-day emergency re-admissions.[1] Hepatic encephalopathy is a potentially life-threatening neuropsychiatric condition associated with liver disease and is associated with increased hospitalisations.[2]

These data were presented at the International Society for Pharmacoeconomics and Outcomes Research Annual European Congress 2016, Austria.

IMPRESS is a retrospective observational study that demonstrates hospital resource use was significantly lower in the post-rifaximin-α initiation period, compared with the pre-rifaximin-α initiation period. Estimated cost reductions* per patient were;1

  • £2,031 in non-elective hospitalisations
  • £9,117 in critical care bed days
  • £121 in emergency room visits
  • £1,518 in 30-day emergency re-admissions

Peter Martin, Chief Operating Officer at Norgine said; “These data reinforce the value that XIFAXAN® 550mg / TARGAXAN® 550mg can bring to patients suffering from hepatic encephalopathy and to healthcare systems overall. By using XIFAXAN® 550mg / TARGAXAN® 550mg which reduces the recurrence of episodes of hepatic encephalopathy, hospitals can decrease the level of resources used. This in turn means lower costs for hospital admissions and bed occupancy.”

Hepatic encephalopathy affects around 10,000 patients in the UK.[3]

XIFAXAN® 550mg / TARGAXAN® 550mg / TIXTELLER® 550mg is reimbursed through healthcare systems in Australia, England and Wales, Germany, Ireland, Italy, Luxembourg, Netherlands, New Zealand, Norway, Scotland, Sweden and Switzerland.

Norgine currently holds marketing rights for XIFAXAN® 550mg (known as TARGAXAN® 550mg in the UK and some other markets) in Australia, Belgium, Denmark, Finland, Germany, Luxembourg, Netherlands, New Zealand, Norway, Republic of Ireland, Sweden, United Kingdom and Switzerland.


* Treatment costs were not included.


Notes to Editors


About the impact of rifaximin-α on non-elective hospital admission and attendance cots in UK patients with hepatic encephalopathy

Between July-08 and May-14, 145 patients within 11 specialist national Health Service (NHS) centres received rifaximin-α for prevention of HE. Hospital admissions and attendances were analysed for the 6 months pre- and post-rifaximin-α initiation. The costs for liver disease admission and attendances were estimated using 2014/2015 prices from published NHS sources, inflated to 2016 costs. All costs are taken from the hospital perspective. This analysis included only patients alive at 6 months post- rifaximin-α initiation with at least 1 admission/attendance in either observed period.


Details of hospital costs in the pre- and post-rifaximin-α initiation periods are shown in the table below.[4]


Resource use parametera


6-month resource use (Mean ± SEM)


Estimated cost per patientc

Estimated cost reduction per patientc

No. of non-elective hospitalisations

per patientb (n=88)


2.1 (±0.2)









1.0 (±0.1)


No. of critical care bed days per

patient (n=19)


7.9 (±2.3)







2.0 (±1.2)


No. of 30-day emergency

readmissions per patient (n=50)


1.7 (±0.3)










0.9 (±0.2)


No. of emergency room visits per

patient (non-admitted) (n=63)


1.9 (±0.3)



< 0.001







1.0 (±0.2)



aAll-cause hospitalisations or visits. bHospitalisations are with overnight stay. cTreatment costs have not been included.


About Hepatic Encephalopathy (HE)

HE is a serious and potentially life-threatening neuropsychiatric condition associated with liver cirrhosis.[5] Severe HE has been estimated to affect 30-45 per cent of people with cirrhosis and symptoms include disorientation, confusion, inappropriate behaviour and personality change.[6] Hepatic encephalopathy results from a damaged liver that is not able to detoxify the blood as efficiently as usual. Toxins build up in the bloodstream and eventually in the brain, which leads to neurological
disorders. 1, [7]

About XIFAXAN® / TARGAXAN® / TIXTAR® / TIXTELLER® 550mg film-coated tablets

XIFAXAN® / TARGAXAN® / TIXTAR® / TIXTELLER® 550mg is indicated for the reduction in recurrence of episodes of overt hepatic encephalopathy in patients ≥18 years of age. TARGAXAN®/ XIFAXAN® / TIXTAR® / TIXTELLER® 550mg is a broad spectrum antibiotic that targets commensal gut bacteria, acting on Gram-negative and Gram-positive aerobes and anaerobes, reducing the excess ammonia produced by the gut bacteria of patients with cirrhosis.


Product under licence from Alfa Wassermann S.p.A. XIFAXAN®, TARGAXAN® and TIXTAR® are registered trademarks of the Alfa Wassermann group of companies, licensed to the Norgine group of companies.


About Norgine

Norgine is a European specialist pharmaceutical company that has been established for over 100 years. In 2015, Norgine’s total revenue was EUR 320 million and the company employs over 1,000 people.

Norgine provides expertise and ‘know how’ in Europe to develop, manufacture and market products that offer real value to healthcare professionals, payers and patients.  Norgine’s approach and infrastructure is integrated and focused upon ensuring that Norgine wins partnership opportunities for growth.

Norgine is headquartered in the Netherlands and its global operations are based in Amsterdam and in Harefield, UK. Norgine owns a R&D site in Hengoed, Wales and two manufacturing sites, one in Hengoed, Wales and one in Dreux, France.

For more information, please visit

In 2012, Norgine established a complementary business Norgine Ventures, supporting innovative healthcare companies through the provision of debt-like financing in Europe and the US. For more information, please visit

NORGINE and the sail logo are trademarks of the Norgine group of companies.

About Alfa Wassermann

Alfa Wassermann is a private pharmaceutical company wholly owned by and subject to the direction and coordination of Alfasigma S.p.A. Alfa Wassermann has its headquarters in Bologna, Italy with its own Research, Development and Manufacturing facilities. In 2015, Alfa Wassermann net sales were €429 million and the company employed over 1,500 people. It has a growing number of affiliate companies in both Europe as well as in emerging markets such as Russia, China and Mexico. Its main product rifaximin-α is a gut-selective antibiotic which is prescribed under the trade names of NORMIX®, XIFAXAN® and others, in 47 countries, including the USA. Alfa Wassermann has also developed other important products: sulodexide (VESSEL®), a heparinoid for thromboembolic diseases, and parnaparin (FLUXUM®), a low molecular weight heparin for the treatment and prophylaxis of deep-vein thrombosis. For more information, please visit Alfa Wassermann’s website at

ALFA WASSERMANN®, the ALFA WASSERMANN logo, NORMIX®, XIFAXAN®, TARGAXAN®, TIXTAR® and TIXTELLER® are registered trademarks of Alfa Wassermann group of companies.

Media Contacts:
Isabelle Jouin, T: +44 (0)1895 453643
Charlotte Andrews, T: +44 (0)1895 453607
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October 2016





[1] Hudson. M. et al. The impact of rifaximin-α on non-elective hospital admission and attendance costs in UK patients with hepatic encephalopathy. Abstract 67307. International Society for Pharmacoeconomics and Outcomes Research (ISPOR) 19th Annual European Congress,
29 October-2 November 2016; Vienna, Austria.

[2] Patidar KR. et al. Covert hepatic encephalopathy is independently associated with poor survival and increased risk of hospitalization. Am J Gastroenterol. 2014. 109. 1757-63.

[3] Fleming K M. et al. Incidence and prevalence of cirrhosis in the United Kingdom, 1992-2001: A general population-based study. Journal of Hepatology 49 (2008) 732-738.

[4] Hudson. M. et al. Poster presented at the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) 19th Annual European Congress, 29 October-2 November 2016; Vienna, Austria. Poster number PGI10.

[5] Morgan M. Chapter 8: Hepatic Encephalopathy in Patients with Cirrhosis. In: Dooley JS, Lok A, Burroughs A, Heathcote J, editors. Sherlock's Diseases of the Liver and Biliary System. 12th ed: Blackwell Publishing Ltd; 2011.

[6] Poordad F. Review article: the burden of hepatic encephalopathy, Aliment Pharmacol Ther 2006;25 (S1):3-9.

[7] Mullen KD. Review of the final report of the 1998 Working Party on definition, nomenclature and diagnosis of hepatic encephalopathy. Aliment Pharmacol Ther. 2007 Feb;25 Suppl 1:11-6.