Cost-effectiveness analysis of Daclatasvir/Sofosbuvir for the treatment of the HCV patients failed after the first line with second generation of DAAs in Italy

Ruggeri, Matteo; Rolli, Francesca Romana; Kondili, L.A.; Drago, Carlo; Solda, F De; Nappi, Carmela; Cicchetti, Americo

doi:10.1080/14737167.2019.1537784

Cited by 6 publications

(4 citation statements)

References 19 publications

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“…In a previous study in Italy in which patients treated in 2015 were evaluated using the same methodology, costs saved on avoided clinical events did not translate into a positive return on investment 10 . This was because of the higher price of DAAs and also by treating patients with cirrhosis, which still accrued higher costs despite viral eradication 41 …”

Section: Discussionmentioning

confidence: 97%

“…10 This was because of the higher price of DAAs and also by treating patients with cirrhosis, which still accrued higher costs despite viral eradication. 41 Generally, these estimations could vary given different progression rates. However, as seen by the sensitivity analysis results, a return of investment is expected within 10 years in all countries except Romania.…”

Section: Discussionmentioning

confidence: 99%

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The impact of direct acting antivirals on hepatitis C virus disease burden and associated costs in four european countries

Mennini

Marcellusi

Scott

et al. 2021

Liver International

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Background and Aims:We assessed the clinical and economic impact of direct-acting antiviral (DAA) therapy for hepatitis C virus (HCV) in England, Italy, Romania and Spain.Methods: An HCV progression Markov model was developed considering DAA eligibility and population data during the years 2015-2019. The period of time to recover the investment in DAAs was calculated as the cost saved by avoiding estimated clinical events for 1000 standardized treated patients. A delayed treatment scenario because of coronavirus disease (COVID-19) was also developed. Results:The estimated number of avoided hepatocellular carcinoma, decompensated cirrhosis and liver transplantations over a 20-year time horizon was: 1,057 in England;

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

The impact of direct acting antivirals on hepatitis C virus disease burden and associated costs in four european countries

Mennini

Marcellusi

Scott

et al. 2021

Liver International

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“…(1) Transitional Probabilities: The transitional probabilities between the different study states were extracted from domestic and foreign studies on hepatitis C (26)(27)(28)(29)(30)(31)(32). All-cause mortality probabilities were obtained for age and gender data from Iran's 2018 life table (33).…”

Section: Model Parametersmentioning

confidence: 99%

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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“…I costi sanitari associati a ciascuno stato di salute previsto dal modello di Markov sono stati estrapolati da differenti studi sull'HCV condotti in ambito nazionale (Tab. IV) (37,38).…”

Section: Costo-efficacia Incrementaleunclassified

Cost-effectiveness analysis with direct-acting antivirals in a cohort of HCV-infected inmates in Italy

Ravasio¹,

Lucania

Ranieri

et al. 2020

abtpn

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Objective: To evaluate the cost-effectiveness of a strategy based on direct-acting antivirals (DAAs) versus no drug strategy in HCV-infected inmates, from the perspective of the Italian National Health System (iNHS). Methods: A previous Markov model was adapted to the Italian setting to evaluate the direct medical costs and health outcomes (quality-adjusted life years, QALY) throughout the life of HCV-infected inmates. Epidemiological data, patient characteristics (genotype, METAVIR classification), DAAs sustained virological response (SVR), annual likelihood of transition, treatment costs and utilities were gathered from the literature. The DAAs strategy included the administration of elbasvir/grazoprevir or sofosbuvir/velpatasvir or glecaprevir/pibrentasvir. Direct medical costs and QALYs were discounted at a 3.0% annual rate. Cost-effectiveness was evaluated as incremental cost-effectiveness ratio (€, 2019) per QALY gained. A deterministic sensitivity analysis (DSA) was performed. Results: Over a lifetime horizon, the DAAs strategy showed higher health costs per patient compared to no drugs strategy in the base-case analysis (€ 42,571 vs. € 26,119). However, it was associated with an increase of QALYs gained (21.14 vs. 15.67), showing an incremental cost-effectiveness ratio of € 3,010 per QALY. The sensitivity analysis confirmed the base-case results. Conclusions: Extending the DAAs treatment to HCV-infected inmates was estimated to be cost effective from the perspective of the Italian NHS, regardless genotype and METAVIR classification.

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Cost-effectiveness analysis of Daclatasvir/Sofosbuvir for the treatment of the HCV patients failed after the first line with second generation of DAAs in Italy

Cited by 6 publications

References 19 publications

The impact of direct acting antivirals on hepatitis C virus disease burden and associated costs in four european countries

The impact of direct acting antivirals on hepatitis C virus disease burden and associated costs in four european countries

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

Cost-effectiveness analysis with direct-acting antivirals in a cohort of HCV-infected inmates in Italy

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