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.
European Association for the Study of the Liver (EASL). 2014
Leleu H, Blachier M, Rosa I. J Viral Hepat 2014;1–7
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.
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