Cost of treating hepatitis C in Germany

Stahmeyer, Jona T.; Rossol, S.; Bert, F; Antoni, Christoph; Demir, Münevver; Hinrichsen, Holger; Hüppe, D; Teuber, G.; Wiebner, B.; Wedemeyer, Heiner; Krauth, Christian

doi:10.1097/meg.0000000000000181

Cited by 8 publications

(3 citation statements)

References 26 publications

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“…The cost-effectiveness of HCV therapy has been subject to extensive research in Germany and served as a proof of concept to establish the efficiency frontier method [ 27 , 28 ]. Since the introduction of DAAs, cost-effectiveness analysis of drugs became more important because antiviral treatment became a major cost component in overall HCV treatment costs [ 29 ]. Other studies used incremental life years or QALYs as a measure of benefit for DAAs [ 20 , 30 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of Interferon-free therapy for Hepatitis C in Germany - an application of the efficiency frontier approach

et al. 2015

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BackgroundThe approval of direct-acting antivirals for Interferon-free treatment revolutionized the therapy of chronic Hepatitis C infection. As of August 2014, two treatment regimens for genotype 1 infection received conditional approval in the European Union: Sofosbuvir and Ribavirin for 24 weeks and Sofosbuvir and Simeprevir with or without Ribavirin for 12 weeks. We aim to analyze the cost-effectiveness of both regimens in Germany.MethodsWe set up a Markov model with a lifetime horizon to simulate immediate treatment success and long-term disease progression for treatment-naive patients. The model analyzes both short-term and long-term costs and benefits from the perspective of the German Statutory Health Insurance. We apply the efficiency frontier method, which was suggested by German Institute for Quality and Efficiency in Health Care for cost-effectiveness analysis in Germany.ResultsThe efficiency frontier is defined by dual therapy and first generation direct-acting antiviral Boceprevir, yielding a maximum of € 1,447.69 per additional percentage point of sustained virologic response gained. Even without rebates, Sofosbuvir/Simeprevir is very close with € 1,560.13 per additional percentage point. It is both more effective and less expensive than Sofosbuvir/Ribavirin.ConclusionsIn addition to higher sustained virologic response rates, new direct-acting antivirals save long-term costs by preventing complications such as liver cirrhosis, hepatocellular carcinoma and ultimately liver transplants, thereby offsetting part of higher drug costs. Our findings are in line with the guidance published by German Society for Gastroenterology, Digestive and Metabolic Diseases, which recommends Sofosbuvir/Simeprevir for Interferon ineligible or intolerant patients.

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Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of Interferon-free therapy for Hepatitis C in Germany - an application of the efficiency frontier approach

et al. 2015

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“…HCV-related clinical events pose a significant economic burden in terms of both direct medical costs (such as pharmacy- and treatment-related) and indirect costs (work productivity loss due to absenteeism and/or presenteeism) [ 1 ]. The economic burden of HCV has been documented in Europe [ 16 , 17 ], including data from Germany [ 18 ]. However, data that specifically estimate the economic impact attributable to CHC-related EHCs for Germany alone are unavailable.…”

Section: Introductionmentioning

confidence: 99%

Clinical and Economic Burden of Hepatic and Extrahepatic Complications from Chronic Hepatitis C: A Retrospective Analysis of German Sickness Fund Data

et al. 2018

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IntroductionGerman data regarding the burden of complications from chronic hepatitis C (CHC) virus infection are limited. To address this issue, this study evaluates the clinical and economic burden of hepatic and extrahepatic complications (EHCs) associated with CHC in Germany.MethodsThis retrospective, cross-sectional study used claims data from the Betriebskrankenkasse German sickness fund (2007–2014) to assess the risks and medical costs of hepatic complications and EHCs, including conditions that are prevalent and behavioral factors associated with CHC. Prevalence, incidence, and risks were calculated for 1:1 matched patients with and without CHC (n = 3994). All-cause cost, medical costs related to hepatic and EHCs, as well as CHC-related and non-CHC-related pharmacy costs (adjusted to the 2016 Euro rate), were calculated and compared between 1:5 matched patients with (n = 8425) and without CHC (n = 42,125).ResultsPatients with CHC had a 3-fold higher risk for any EHC (OR = 3.0; P < 0.05) and higher EHC-related medical costs (adjusted difference, €1606; P < 0.01) compared with patients without CHC. Total costs (€10,108 vs. €5430), hepatic complication-related medical costs (€1425 vs. €556), EHC-related costs (€3547 vs. €1921), CHC-related pharmacy costs (€577 vs. €116), and non-CHC-related pharmacy costs (€3719 vs. €1479) were all significantly greater for patients with CHC compared with patients without CHC. EHC-related medical costs were a major contributor to the higher all-cause medical (84.4%) and total (44.3%) cost differences between patients with CHC and the matched sample of patients without CHC.ConclusionCHC is associated with substantial clinical and economic burden in Germany, largely due to hepatic complications and EHCs.FundingAbbvie Inc.

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“…When evaluating the social impact of a disease, several health-related indicators should be considered to be related directly to the impact caused by health problems on well-being (mortality, mobility, disability and health-related quality of life). In addition to these health outcomes, it is also possible to identify other indicators that can help us to understand better the impact of a disease from a social perspective; one of them is the healthcare cost associated with HCV infection 10 – 13 . However, studies considering other non-healthcare costs caused by HCV infection are less frequent.…”

Section: Introductionmentioning

confidence: 99%

Labour productivity losses caused by premature death associated with hepatitis C in Spain

Oliva‐Moreno

Peña-Longobardo

Alonso

et al. 2015

European Journal of Gastroenterology &Amp; Hepatology

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Cost of treating hepatitis C in Germany

Cited by 8 publications

References 26 publications

Cost-effectiveness of Interferon-free therapy for Hepatitis C in Germany - an application of the efficiency frontier approach

Cost-effectiveness of Interferon-free therapy for Hepatitis C in Germany - an application of the efficiency frontier approach

Clinical and Economic Burden of Hepatic and Extrahepatic Complications from Chronic Hepatitis C: A Retrospective Analysis of German Sickness Fund Data

Labour productivity losses caused by premature death associated with hepatitis C in Spain

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