Cost-utility analysis of interferon-free treatments for patients with early-stage genotype 1 hepatitis C virus in Brazil

Ferreira, Vinicíus Lins; Leonart, Letícia Paula; Pedroso, Fiona L.; Pontarolo, Roberto

doi:10.1590/0037-8682-0594-2019

Cited by 2 publications

(3 citation statements)

References 6 publications

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“…Ferreira et al found that the GLE/PIB regimen is costeffective for treating Brazilian patients with HCV genotype 1 infection in the early fibrosis stages. It is superior to the sofosbuvir + velpatasvir regimen and the sofosbuvir + daclatasvir regimen (11). A Japanese study reached a similar conclusion that the GLE/PIB regimen is the best strategy among the four DAA regimens (7).…”

Section: Discussionmentioning

confidence: 89%

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Cost-effectiveness analysis of glecaprevir/pibrentasvir regimen for treating Chinese patients with chronic hepatitis C genotype 1 and genotype 2 infection

Zhou

Wu²,

et al. 2021

Ann Palliat Med

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Background: Hepatitis C virus (HCV) infection is an important health threat in China to which direct acting antivirals (DAAs) are very effective. In 2019, another novel DAA glecaprevir/pibrentasvir (GLE/ PIB) was officially approved. Knowledge of its cost-effectiveness would be informative for clinical decisionmaking but has not been evaluated. This study aims to evaluate the cost-effectiveness of GLE/PIB to inform policy-making on drug reimbursement and HCV eradication.Methods: Markov models were developed from the payers' perspective and simulated the lifetime experience of adult patients chronically infected with HCV genotype 1 or genotype 2. Two regimens, GLE/ PIB and pegylated interferon (pegIFN) plus ribavirin (RBV), were compared in cost and quality adjusted life years (QALY) with both outcomes being discounted to 2020 values. The incremental cost-effectiveness ratio (ICER) was computed to reflect the incremental benefit of GLE/PIB versus pegIFN + RBV. The robustness of the model outcomes was examined using deterministic and probabilistic sensitivity analysis (PSA) to identify influential parameters and to assess the probability of GLE/PIB being cost-effective. The GDP per capita in China in 2019 ($10,275) was used as the threshold for cost-effectiveness.

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Section: Discussionmentioning

confidence: 89%

“…In comparison, the corresponding SVRs when using the first line agents pegylated IFN (pegIFN) + RBV were 57.88% and 81.32% respectively. Studies in Japan and Brazil have indicated that GLE/PIB could be an economical option for HCV treatment given its excellent clinical efficacy (7,11).…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness analysis of glecaprevir/pibrentasvir regimen for treating Chinese patients with chronic hepatitis C genotype 1 and genotype 2 infection

Zhou

Wu²,

et al. 2021

Ann Palliat Med

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“…In this study, the QALYs and costs of the DCV/SOF regimen were more than those of LDV/SOF; however, by comparing the ICER obtained with the threshold, DCV/SOF was more cost-effective than LDV/SOF. Confirming these results, Ruggeri et al ( 2019) conducted a study to assess the cost-effectiveness of two regimens DCV/SOF and LDV/SOF, (51). Moreover, the results of the oneway sensitivity analysis showed that the VEL/SOF regimen was more cost-effective than the two other medical strategies, which were placed in the acceptable range below the threshold and obtained the best results considering the costs.…”

Section: Discussionmentioning

confidence: 94%

Cost-utility Analysis of Second-generation Direct-acting Antivirals for Hepatitis C

et al. 2021

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Background: Hepatitis C virus (HCV) can lead to increased mortality, disability, and liver transplantation if left untreated, and it is associated with a possible increase in disease burden in the future, all of which would surely have a significant impact on the health system. New antiviral regimens are effective in the treatment of the disease yet expensive. Objectives: The purpose of the present study was to assess the cost-effectiveness of three medication regimens, namely, ledipasvir/sofosbuvir (LDV/SOF), velpatasvir/sofosbuvir, and daclatasvir/sofosbuvir (DCV/SOF) for HCV patients with genotype 1 in Iran. Methods: A Markov model with a lifetime horizon was developed to predict the costs and outcomes of the three mentioned medication therapy strategies. The final outcome of the study was quality-adjusted life-years (QALYs), which was obtained using the previously published studies. The study was conducted from the perspective of the Health Ministry; therefore, only direct medical costs were estimated. The results were provided as the incremental cost-effectiveness ratio (ICER) per QALY. Ultimately, the one-way and probabilistic sensitivity analyses were used to measure the strength of study results. Results: The results showed that the QALYs for LDV/SOF, DCV/SOF, and VEL/SOF were 13.25, 13.94, and 14.61, and the costs were 4,807, 7,716, and 4,546$, respectively. The VEL/SOF regimen had lower costs and higher effectiveness than the LDV/SOF and DCV/SOF regimens, making it a dominant strategy. The tornado diagram results showed that the study results had the highest sensitivity to chronic hepatitis C (CHC) and compensated cirrhosis (CC) state costs. Moreover, the scatter plots showed that the VEL/SOF was the dominant therapeutic strategy in 73% of the simulations compared to LDV/SOF and 66% of the simulations compared to DCV/SOF; moreover, it was in the acceptable region in 92% of the simulations and below the threshold. Therefore, it was considered the most cost-effective strategy. Moreover, the results showed that DCV/SOF was in the acceptable region below the threshold in 69% of the simulations compared to LDV/SOF. Therefore, the DCV/SOF regimen was more cost-effective than LDV/SOF. Conclusions: According to the present study results, it is suggested that the VEL/SOF regimen be used as the first line of therapy in patients with HCV genotype 1. Moreover, DCV/SOF can be the second-line medication regimen.

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Cost-utility analysis of interferon-free treatments for patients with early-stage genotype 1 hepatitis C virus in Brazil

Cited by 2 publications

References 6 publications

Cost-effectiveness analysis of glecaprevir/pibrentasvir regimen for treating Chinese patients with chronic hepatitis C genotype 1 and genotype 2 infection

Cost-effectiveness analysis of glecaprevir/pibrentasvir regimen for treating Chinese patients with chronic hepatitis C genotype 1 and genotype 2 infection

Cost-utility Analysis of Second-generation Direct-acting Antivirals for Hepatitis C

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