Cost-effectiveness of sofosbuvir-based triple therapy for untreated patients with genotype 1 chronic hepatitis C

Antonio Gasbarrini, Rosa Anna Bruno, Salvatore Petta, Giuseppe Cabibbo, Marco Enea, Fabio Salvatore Macaluso, Antonella Plaia, Raffaele Bruno, Antonio Craxì, Calogero Cammà

Risultato della ricerca: Contributo in rivistaArticolo in rivista

71 Citazioni (Scopus)

Abstract

We assessed the cost-effectiveness of sofosbuvir (SOF)-based triple therapy (TT) compared with boceprevir (BOC)- and telaprevir (TVR)-based TT in untreated genotype 1 (G1) chronic hepatitis C (CHC) patients discriminated according to IL28B genotype, severity of liver fibrosis, and G1 subtype. The available published literature provided the data source. The target population was made up of untreated Caucasian patients, aged 50 years, with G1CHC and these were evaluated over a lifetime horizon by Markov model. The study was carried out from the perspective of the Italian National Health Service. Outcomes included discounted costs (in euros at 2013 value), life-years gained (LYG), quality-adjusted life year (QALY), and incremental cost-effectiveness ratio (ICER). Cost of SOF was assumed to be € 3,500 per week, i.e., the price generating a willingness-to-pay threshold of € 25,000 per LYG compared with TVR in the entire population of untreated G1 patients. The robustness of the results was evaluated by one-way deterministic and multivariate probabilistic sensitivity analyses. SOF was cost-effective compared with BOC in all strategies with the exception of cirrhosis and IL28B CC patients. In comparison with TVR-based strategies, SOF was cost-effective in IL28B CT/TT (ICER per LYG € 22,229) and G1a (€ 19,359) patients, not cost-effective in IL28B CC (€45,330), fibrosis F0-F3 (€ 26,444), and in cirrhosis (€ 34,906) patients, and dominated in G1b patients. The models were sensitive to SOF prices and to likelihood of sustained virological response.
Lingua originaleEnglish
pagine (da-a)1692-1705
Numero di pagine14
RivistaHepatology
Volume59
DOI
Stato di pubblicazionePubblicato - 2014

Keywords

  • Antiviral Agents
  • Cost-Benefit Analysis
  • Drug Therapy, Combination
  • Genotype
  • Hepacivirus
  • Hepatitis C, Chronic
  • Humans
  • Oligopeptides
  • Proline
  • Quality-Adjusted Life Years
  • Uridine Monophosphate

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