Drug therapies for chronic hepatitis C infection: a cost-effectiveness analysis

Wong, William; Lee, Karen M.; Singh, Sumeet; Wells, George A.; Feld, Jordan J.; Krahn, Murray

doi:10.9778/cmajo.20160161

Cited by 26 publications

(28 citation statements)

References 38 publications

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“…The availability of DAAs enables highly efficacious treatment of chronic HCV infection [ 22 ]; however, whenever a new drug is approved, particularly if it is a high-impact therapy, an economic assessments should be performed to determine whether the medication will produce real health benefits for patients and cost savings for the healthcare system [ 23 – 26 ].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of health status in patients with hepatitis c treated with and without interferon

Ragusa¹,

Bertino²,

Bruno

et al. 2018

Health Qual Life Outcomes

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BackgroundThe evolution of technology in healthcare has increased the health care’s costs and, the universal healthcare systems, in developed countries, need to ensure proper allocation of resources. Thus, the major issue is assessing the effectiveness of new medical technologies. The evaluation of quality of life in response to new treatments has become a key indicator in chronic conditions for which medical interventions are evaluated not only in terms of increasing the number of expected life years but also in terms of increasing quality of life. The aim of this observational study was to verify whether a simple instrument (EQ-5D-5 L) can capture variations in health-related quality of life (HRQoL) and allow us to evaluate the impact of different drug treatment protocols in patients with hepatitis C virus (HCV) on daily activities.MethodsSixty six patients with HCV were consecutively enrolled in the Hepatology Unit at the University Hospital of Catania “G. Rodolico”. Sixteen patients received new direct-acting-antiviral agents (DAAs) plus pegylated alpha interferon (Peg-α-IFN) protocol (Group A) and 50 DAAs IFN free protocol (Group B).The EQ-5D-5 L® questionnaire and visual analog scale (VAS) were given to both groups to calculate coefficient’s utility. We used the EQ-5D-5 L Crosswalk Index Value Calculator to obtain the utility EQIndex and both parametric and non parametric tests for the statistical analysis.ResultsThe biopsy taken at the beginning of treatment showed comparable cell damage in both groups. The difference in the VAS results was negative for patients who received protocols containing IFN (indicating decreased quality of life),whereas it was positive in patients treated with IFN-free protocols. The baseline EQIndex did not reveal any differences between the two treatment groups. The post-treatment EQIndex was statistically better in the groups that received IFN-free therapy.ConclusionsWhen innovative treatments are introduced into clinical practice, assessing quality of life is mandatory to determine their benefits. The instruments used in the present study are effective in detecting the areas in which improvement has occurred. These instruments can be easily managed by general practitioners for follow up of progression of the disease and referred to the specialist.

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Section: Discussionmentioning

confidence: 99%

Evaluation of health status in patients with hepatitis c treated with and without interferon

Ragusa¹,

Bertino²,

Bruno

et al. 2018

Health Qual Life Outcomes

View full text Add to dashboard Cite

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“…However, there is strong evidence demonstrating the costeffectiveness of hepatitis C treatment for all patient sub groups at all levels of fibrosis. 25,84,85 Increased screening efforts and treatment uptake will be required to meet the World Health Organization targets for elimination of HCV as a public health problem by 2030. This document will be updated annually and revised versions of recommendations will be placed on the Canadian Association for the Study of the Liver website immediately.…”

Section: Methodsmentioning

confidence: 99%

The management of chronic hepatitis C: 2018 guideline update from the Canadian Association for the Study of the Liver

Shah¹,

Bilodeau

Burak

et al. 2018

CMAJ

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102

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“…IFN-free regimens have been demonstrated to be cost-effective compared to IFN-based therapy in some cases 12. However, these studies use data from clinical trials and therefore are not necessarily representative of real-life care.…”

Section: Introductionmentioning

confidence: 99%

The cost of successful antiviral therapy in hepatitis C patients: a comparison of IFN-free versus IFN-based regimens at an individual patient level in Australia

Lee¹,

Driel²,

Crawford³

2017

CEOR

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BackgroundChronic hepatitis C remains a major global health burden with serious long-term consequences if left untreated. Recently the treatment standard of care has shifted to new interferon (IFN)-free drug regimens, which have been shown to be safe and effective. The aim of our study was to assess and compare medical resource utilization and costs of successfully treating patients with IFN-based and IFN-free therapies in Australia.MethodsWe performed a retrospective chart review of 30 HCV-infected patients successfully treated with IFN-based therapy between 2013 and 2015. We also generated a model for a virtual group of 100 genotype 1 (GT1) and 100 genotype 3 (GT3) patients treated with IFN-free therapy derived from national guidelines and clinical trial data.ResultsIn comparison to virtual patients receiving IFN-free therapy, our IFN-treated patients on average had distinctively more liver clinic visits and blood tests. However, mean total cost per patient was $19,164 and $85,300 (AUD) more for GT1 and GT3 patients receiving IFN-free therapy, respectively. This difference was largely accounted for by higher antiviral drug costs. Of our 30 patients treated with IFN, total mean cost per patient during the study period was $33,595.ConclusionResource utilization is lower with IFN-free treatment, which reflects the reduced need for patient monitoring and improved side-effect profile of these new drugs. However, total costs are still largely dominated by antiviral drug costs, representing a huge burden on national budgets. Our insight into resource utilization and costs associated with both types of treatment can serve as a reference for future studies.

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Drug therapies for chronic hepatitis C infection: a cost-effectiveness analysis

Cited by 26 publications

References 38 publications

Evaluation of health status in patients with hepatitis c treated with and without interferon

Evaluation of health status in patients with hepatitis c treated with and without interferon

The management of chronic hepatitis C: 2018 guideline update from the Canadian Association for the Study of the Liver

The cost of successful antiviral therapy in hepatitis C patients: a comparison of IFN-free versus IFN-based regimens at an individual patient level in Australia

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