PIN57 Cost-Effectiveness of the New Guidelines for the Prevention of Mother to Child Transmission of HIV in Uganda

Abstract

tions. Seven state Markov model (chronic HCV, sustained virological response, compensated cirrhosis, hepatocellulare carcinoma, liver transplantation and death) was used to estimate clinical effects and costs in lifetime horizon, from Polish public payer perspective. Direct medical costs were considered. Separate analysis was done for genotypes 1,4 (48-week treatment) and genotypes 2,3 (24week treatment). Clinical practice and cost data were gathered from clinical experts or based on the National Health Fund and Ministry of Health published price lists. Sensitivity analysis was conducted in order to assess the robustness of the results. RESULTS: Genotypes 1 and 4: total costs were 92 036 PLN (1 Euroϭ3.96 PLN) for PegIFN␣2a and 87 793 PLN for PegIFN␣2b. Average survival of HCV patient treated with PegIFN␣2a was 27.9 life years (LY) and 14.83 quality adjusted life years (QALY) and treated with PegIFN␣2b was 27.63 LYs and 14.61 QALYs. The incremental cost-effectiveness ratio was 15 878 PLN/LYG and incremental cost-utility ratio was 19 763 PLN/QALY. Values of both ratios fall below the cost-effectiveness threshold assumed in Poland (100 000 PLN/LYG or QALY). Genotypes 2 and 3: Total costs were 32 849 PLN for PegIFN␣2a and 38 071 PLN for PegIFN␣2b. Average survival of HCV patient treated with PegIFN␣2a was 30.79 LYs and 17.15 QALYs and treated with PegIFN␣2b was 30.20 LYs and 16.68 QALYs. The PegIFN␣2a dominated PegIFN␣2b. The results were confirmed in sensitivity analysis. CONCLUSIONS: PegIFN␣2a is a clinically effective and safe treatment for HCV patients and is highly cost-effective (or dominant) from Polish public payer perspective.