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Cost-Effectiveness of Treating Hepatitis C with Sofosbuvir/Ledipasvir in Germany

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  • Jona T Stahmeyer
  • Siegbert Rossol
  • Sebastian Liersch
  • Ines Guerra
  • Christian Krauth

Abstract

Background: Infections with the hepatitis C virus (HCV) are a global public health problem. Long-term consequences are the development of liver cirrhosis and hepatocellular carcinoma. Newly introduced direct acting antivirals, especially interferon-free regimens, have improved rates of sustained viral response above 90% in most patient groups and allow treating patients who were ineligible for treatment in the past. These new regimens have replaced former treatment and are recommended by current guidelines. However, there is an ongoing discussion on high pharmaceutical prices. Our aim was to assess the long-term cost-effectiveness of treating hepatitis C genotype 1 patients with sofosbuvir/ledipasvir (SOF/LDV) treatment in Germany. Material and Methods: We used a Markov cohort model to simulate disease progression and assess cost-effectiveness. The model calculates lifetime costs and outcomes (quality-adjusted life years, QALYs) of SOF/LDV and other strategies. Patients were stratified by treatment status (treatment-naive and treatment-experienced) and absence/presence of cirrhosis. Different treatment strategies were compared to prior standard of care. Sensitivity analyses were performed to evaluate model robustness. Results: Base-case analyses results show that in treatment-naive non-cirrhotic patients treatment with SOF/LDV dominates the prior standard of care (is more effective and less costly). In cirrhotic patients an incremental cost-effectiveness ratio (ICER) of 3,383 €/QALY was estimated. In treatment-experienced patients ICERs were 26,426 €/QALY and 1,397 €/QALY for treatment-naive and treatment-experienced patients, respectively. Robustness of results was confirmed in sensitivity analyses. Conclusions: Our analysis shows that treatment with SOF/LDV is cost-effective compared to prior standard of care in all patient groups considering international costs per QALY thresholds.

Suggested Citation

  • Jona T Stahmeyer & Siegbert Rossol & Sebastian Liersch & Ines Guerra & Christian Krauth, 2017. "Cost-Effectiveness of Treating Hepatitis C with Sofosbuvir/Ledipasvir in Germany," PLOS ONE, Public Library of Science, vol. 12(1), pages 1-18, January.
    • Handle: RePEc:plo:pone00:0169401
    DOI: 10.1371/journal.pone.0169401
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    References listed on IDEAS

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    1. Uwe Siebert & Gaby Sroczynski & Jürgen Wasem & Wolfgang Greiner & Ulrike Ravens-Sieberer & Pamela Aidelsburger & Bärbel Kurth & Monika Bullinger & J.-Matthias Schulenburg & John Wong & Siegbert Rossol, 2005. "Using competence network collaboration and decision-analytic modeling to assess the cost-effectiveness of interferon α-2b plus ribavirin as initial treatment of chronic hepatitis C in Germany," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 6(2), pages 112-123, June.
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    Cited by:

    1. Brekke, Kurt R. & Dalen, Dag Morten & Straume, Odd Rune, 2023. "The price of cost-effectiveness thresholds under therapeutic competition in pharmaceutical markets," Journal of Health Economics, Elsevier, vol. 90(C).
    2. Afschin Gandjour, 2020. "Cost-effectiveness of sofosbuvir in hepatitis C genotype 1 infection in Germany: A reanalysis of published results," PLOS ONE, Public Library of Science, vol. 15(10), pages 1-13, October.

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