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Will Sofosbuvir/Ledipasvir (Harvoni) Be Cost-Effective and Affordable for Chinese Patients Infected with Hepatitis C Virus? An Economic Analysis Using Real-World Data

Author

Listed:
  • Guo-Feng Chen
  • Lai Wei
  • Jing Chen
  • Zhong-Ping Duan
  • Xiao-Guang Dou
  • Qing Xie
  • Wen-Hong Zhang
  • Lun-Gen Lu
  • Jian-Gao Fan
  • Jun Cheng
  • Gui-Qiang Wang
  • Hong Ren
  • Jiu-Ping Wang
  • Xing-Xiang Yang
  • Zhan-Sheng Jia
  • Qing-Chun Fu
  • Xiao-Jin Wang
  • Jia Shang
  • Yue-Xin Zhang
  • Ying Han
  • Ning Du
  • Qing Shao
  • Dong Ji
  • Fan Li
  • Bing Li
  • Jia-Liang Liu
  • Xiao-Xia Niu
  • Cheng Wang
  • Vanessa Wu
  • April Wong
  • Yu-Dong Wang
  • Jin-Lin Hou
  • Ji-Dong Jia
  • Hui Zhuang
  • George Lau

Abstract

Background: Little is known on the cost-effectiveness of novel regimens for hepatitis C virus (HCV) compared with standard-of-care with pegylated interferon (pegIFN) and ribavirin (RBV) therapy in developing countries. We evaluated cost-effectiveness of sofosbuvir/ledipasvir for 12 weeks compared with a 48-week pegIFN-RBV regimen in Chinese patients with genotype 1b HCV infection by economic regions. Methods: A decision analytic Markov model was developed to estimate quality-adjusted-life-years, lifetime cost of HCV infection and incremental cost-effectiveness ratios (ICERs). SVR rates and direct medical costs were obtained from real-world data. Parameter uncertainty was assessed by one-way and probabilistic sensitivity analyses. Threshold analysis was conducted to estimate the price which can make the regimen cost-effective and affordable. Results: Sofosbuvir/ledipasvir was cost-effective in treatment-experienced patients with an ICER of US$21,612. It varied by economic regions. The probability of cost-effectiveness was 18% and 47% for treatment-naive and experienced patients, and it ranged from 15% in treatment-naïve patients in Central-China to 64% in treatment-experienced patients in Eastern-China. The price of 12-week sofosbuvir/ledipasvir treatment needs to be reduced by at least 81% to US$18,185 to make the regimen cost-effective in all patients at WTP of one time GDP per capita. The price has to be US$105 to make the regimen affordable in average patients in China. Conclusion: Sofosbuvir/ledipasvir regimen is not cost-effective in most Chinese patients with genotype 1b HCV infection. The results vary by economic regions. Drug price of sofosbuvir/ledipasvir needs to be substantially reduced when entering the market in China to ensure the widest accessibility.

Suggested Citation

  • Guo-Feng Chen & Lai Wei & Jing Chen & Zhong-Ping Duan & Xiao-Guang Dou & Qing Xie & Wen-Hong Zhang & Lun-Gen Lu & Jian-Gao Fan & Jun Cheng & Gui-Qiang Wang & Hong Ren & Jiu-Ping Wang & Xing-Xiang Yang, 2016. "Will Sofosbuvir/Ledipasvir (Harvoni) Be Cost-Effective and Affordable for Chinese Patients Infected with Hepatitis C Virus? An Economic Analysis Using Real-World Data," PLOS ONE, Public Library of Science, vol. 11(6), pages 1-13, June.
    • Handle: RePEc:plo:pone00:0155934
    DOI: 10.1371/journal.pone.0155934
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    References listed on IDEAS

    as
    1. Yu, Hao, 2015. "Universal health insurance coverage for 1.3 billion people: What accounts for China's success?," Health Policy, Elsevier, vol. 119(9), pages 1145-1152.
    2. Alena M Pfeil & Oliver Reich & Ines M Guerra & Sandrine Cure & Francesco Negro & Beat Müllhaupt & Daniel Lavanchy & Matthias Schwenkglenks, 2015. "Cost-Effectiveness Analysis of Sofosbuvir Compared to Current Standard Treatment in Swiss Patients with Chronic Hepatitis C," PLOS ONE, Public Library of Science, vol. 10(5), pages 1-20, May.
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    Cited by:

    1. Yin Liu & Hui Zhang & Lei Zhang & Xia Zou & Li Ling, 2020. "Economic Evaluation of Hepatitis C Treatment Extension to Acute Infection and Early-Stage Fibrosis Among Patients Who Inject Drugs in Developing Countries: A Case of China," IJERPH, MDPI, vol. 17(3), pages 1-13, January.
    2. Pingyu Chen & Min Jin & Yang Cao & Hongchao Li, 2021. "Cost-Effectiveness Analysis of Oral Direct-Acting Antivirals for Chinese Patients with Chronic Hepatitis C," Applied Health Economics and Health Policy, Springer, vol. 19(3), pages 371-387, May.
    3. Yun Lu & Xiuze Jin & Cheng-a-xin Duan & Feng Chang, 2018. "Cost-effectiveness of daclatasvir plus asunaprevir for chronic hepatitis C genotype 1b treatment-naïve patients in China," PLOS ONE, Public Library of Science, vol. 13(4), pages 1-12, April.

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