Background Hepatitis C virus infection constitutes a major public health problem worldwide due to its long-term impact, ranging from extensive fibrosis to hepatocellular carcinoma. Since the approval of direct-acting antivirals (DDAs), treatment-naïve and -experienced patients with compensated disease have been able to benefit from a broad choice of drug combinations.¹ Nowadays due to financial constraints the need for a financial evaluation of the innovative treatments is recognised.

Purpose To perform a cost-utility analysis of sofosbuvir-based treatment versus standard care in our Hospital for treatment-naïve genotype 1 and 3 patients (ribavirin/peg-interferon followed by boceprevir/ribavirin/peg-interferon in genotype 1 and ribavirin/peg-interferon in genotype 3).

Material and methods Review of recent literature data to evaluate the efficacy of the therapeutic options being analysed. A decision-analytic Markov model was used to estimate long-term health outcomes.^2,3 The cost was calculated based on the direct costs of the drugs (2014).

Results The incremental cost-efficacy ratio calculated for sofosbuvir-based treatment for untreated genotype 1 patients was €38,455.53. For untreated genotype 3 patients, the ribavirin/peg-interferon option was dominant versus sofosbuvir-based treatment.

Conclusion Sofosbuvir-based treatment can be considered a cost-effective option for genotype 1 patients, depending on willingness-to-pay for a quality-adjusted life year. Equally a cost-utility evaluation should be assessed for more than two dozen possible therapeutic schemes.

References

1. European Association for the Study of the Liver (EASL). 2014

2. Leleu H, Blachier M, Rosa I. J Viral Hepat 2014;1–7

3. Hsu PC, Federico CA, Krajden M, Yoshida EM, Bremner KE, Anderson FH, Weiss AA, Krahn MD. J Gastroenterol Hepatol 2012;27:149–57

ReferencesNo conflict of interest.