Background Viral hepatitis is a major public health problem, affecting millions of people worldwide. There is a great need for cost effectiveness analysis in real life settings as newly introduced treatment strategies result in high sustained viral response (SVR) rates but are more costly.
Purpose The aim of the study was to assess outcomes and costs of treating patients with chronic hepatitis C in clinical practice in a tertiary hospital.
Material and methods Retrospective observational study including hepatitis C patients who completed treatment with new drugs between January 2012 and April 2015. Measured variables were: age, sex, antiviral agent used and treatment costs. The information sources used were computerised medical records. Treatments with boceprevir (BOC), telaprevir (TLV), simeprevir (SIM), sofosbuvir (SOF) and simeprevir+sofosbuvir (SIM+SOF) were analysed. Patients who had SVR at 12 weeks post treatment and were awaiting the outcome at 24 weeks post-treatment were considered cured. Selling laboratory prices for each treatment were considered, given that BOC is provided at no cost from the 32nd week. The formula used to calculate the average cost per SVR in treated patients = spendings for all patients treated with the selected drug/number of patients showing SVR at week 24 week. The cost of non-successful treatments = cost of treatment dispensed to patients not reaching SVR with the selected drug/number of patients not reaching SVR.
Results 138 patients with a mean age of 53.2 years were included (67.4% men). 45.6% received TLV, 21% BOC, 16.7% SIM+SOF, 11.6% SIM and 5.1% SOF. The percentage of cured patients was: BOC 69%, TLV 46%, SIM 75%, SOF 100% and SIM+SOF 86.96%. Average costs per SVR in each treatment were: BOC €29542, TLV €42636, SIM €31466, SOF €35043 and SIM+SOF €57649. Average costs for not achieving SVR in each treatment were: BOC €16519, TLV €16716, SIM €17599, SOF €0 and SIM+SOF €50130.
Conclusion Sofosbuvir seems to be the most cost effective treatment analysed in real life settings but future studies involving more patients are needed to confirm these results.
Our insight on real life treatment outcomes and costs can serve as a reference for a comparison with other treatments.
References and/or Acknowledgements 1 Stahmeyer JT. J Viral Hepat 2015 Sep
No conflict of interest.
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