Background Recently, there have been major improvements in hepatitis C cure rates, mostly because of the use of the new protease inhibitor (PI) drugs, but this entails a significant increase in treatment costs. The application of stopping rules, included in their product information, can avoid adverse effects and save costs to the Health System.
Purpose To analyse the costs of curative treatment and costs associated with PI treatment failure, including those arising from non-compliance with stopping rules for boceprevir (BOC) and telaprevir (TVR) and to establish some measures to reduce costs.
Material and methods Retrospective observational study of PI treatment costs in two hospitals, from January 2012 to February 2014. Data were obtained from the pharmacotherapy management database Farmatools.
Results 56 patients were treated with triple therapy: 18 received boceprevir and 38 telaprevir. In each group (BOC and TVR): 4 (22%) and 23 (60.5%) were treatment-naïve; 3 (17%) and 9 (24%) were prior relapsers; 4 (22%) and 3 (8%) were prior partial responders and 7 (39%) and 3 (8%) were prior null responders. Overall, 40 (70%) patients were cured. We spent €921,600 on telaprevir and €346,500 on boceprevir. Since 39 and 11 patients were cured in each group, the cost benefit was €31,779 and €31,500 respectively. However, we spent €277,157 on patients whose treatment finally failed (22% of the total cost). In one of the hospitals, we analysed the costs arising from non-compliance with stopping rules, which were €5,333 for telaprevir and €17,067 for boceprevir.
Conclusion We found efficacy and cost differences between the two PIs, probably due to the different characteristics of the populations treated. Good coordination between pharmacist and physicians from the beginning of each treatment as well as early pharmaceutical intervention may result in minimising the costs of the triple therapy, especially those associated with non-compliance with stopping rules.
References and/or acknowledgements No conflict of interest.
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