IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0176503.html
   My bibliography  Save this article

Cost-effectiveness of hepatitis C treatment using generic direct-acting antivirals available in India

Author

Listed:
  • Rakesh Aggarwal
  • Qiushi Chen
  • Amit Goel
  • Nicole Seguy
  • Razia Pendse
  • Turgay Ayer
  • Jagpreet Chhatwal

Abstract

Background & aims: Availability of directly-acting antivirals (DAAs) has changed the treatment landscape of hepatitis C virus (HCV) infection. The high price of DAAs has restricted their use in several countries. However, in some countries such as India, generic DAAs are available at much cheaper price. This study examined whether generic DAAs could be cost-saving and how long it would take for the treatment to become cost-saving/effective. Methods: A previously-validated, mathematical model was adapted to the HCV-infected population in India to compare the outcomes of no treatment versus treatment with DAAs. Model parameters were estimated from published studies. Cost-effectiveness of HCV treatment using available DAAs was calculated, using a payer’s perspective. We estimated quality-adjusted life years (QALYs), disability-adjusted life years (DALYs), total costs, and incremental cost-effectiveness ratio of DAAs versus no treatment. One-way and probabilistic sensitivity analyses were conducted. Results: Compared with no treatment, the use of generic DAAs in Indian HCV patients would increase the life expectancy by 8.02 years, increase QALYs by 3.89, avert 19.07 DALYs, and reduce the lifetime healthcare costs by $1,309 per-person treated. Treatment became cost-effective within 2 years, and cost-saving within 10 years of its initiation overall and within 5 years in persons with cirrhosis. Treating 10,000 HCV-infected persons could prevent 3400–3850 decompensated cirrhosis, 1800–2500 HCC, and 4000–4550 liver-related deaths. The results were sensitive to the costs of DAAs, pre- and post-treatment diagnostic tests and management of cirrhosis, and quality of life after sustained virologic response. Conclusions: Treatment with generic DAAs available in India will improve patient outcomes, provide a good value for money within 2 years, and be ultimately cost-saving. Therefore, in this and similar settings, HCV treatment should be a priority from a public health as well an economic perspective.

Suggested Citation

  • Rakesh Aggarwal & Qiushi Chen & Amit Goel & Nicole Seguy & Razia Pendse & Turgay Ayer & Jagpreet Chhatwal, 2017. "Cost-effectiveness of hepatitis C treatment using generic direct-acting antivirals available in India," PLOS ONE, Public Library of Science, vol. 12(5), pages 1-15, May.
    • Handle: RePEc:plo:pone00:0176503
    DOI: 10.1371/journal.pone.0176503
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0176503
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0176503&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0176503?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Swathi Iyengar & Kiu Tay-Teo & Sabine Vogler & Peter Beyer & Stefan Wiktor & Kees de Joncheere & Suzanne Hill, 2016. "Prices, Costs, and Affordability of New Medicines for Hepatitis C in 30 Countries: An Economic Analysis," PLOS Medicine, Public Library of Science, vol. 13(5), pages 1-22, May.
    2. Jagpreet Chhatwal & Tianhua He & Maria A. Lopez-Olivo, 2016. "Systematic Review of Modelling Approaches for the Cost Effectiveness of Hepatitis C Treatment with Direct-Acting Antivirals," PharmacoEconomics, Springer, vol. 34(6), pages 551-567, June.
    3. Janel Hanmer & William F. Lawrence & John P. Anderson & Robert M. Kaplan & Dennis G. Fryback, 2006. "Report of Nationally Representative Values for the Noninstitutionalized US Adult Population for 7 Health-Related Quality-of-Life Scores," Medical Decision Making, , vol. 26(4), pages 391-400, July.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Yashika Chugh & Radha Krishan Dhiman & Madhumita Premkumar & Shankar Prinja & Gagandeep Singh Grover & Pankaj Bahuguna, 2019. "Real-world cost-effectiveness of pan-genotypic Sofosbuvir-Velpatasvir combination versus genotype dependent directly acting anti-viral drugs for treatment of hepatitis C patients in the universal cove," PLOS ONE, Public Library of Science, vol. 14(8), pages 1-24, August.
    2. Antoine Chaillon & Sanjay R Mehta & Martin Hoenigl & Sunil S Solomon & Peter Vickerman & Matthew Hickman & Britt Skaathun & Natasha K Martin, 2019. "Cost-effectiveness and budgetary impact of HCV treatment with direct-acting antivirals in India including the risk of reinfection," PLOS ONE, Public Library of Science, vol. 14(6), pages 1-16, June.
    3. Waranya Rattanavipapong & Thunyarat Anothaisintawee & Yot Teerawattananon, 2018. "Revisiting policy on chronic HCV treatment under the Thai Universal Health Coverage: An economic evaluation and budget impact analysis," PLOS ONE, Public Library of Science, vol. 13(2), pages 1-15, February.
    4. Anita W M Suijkerbuijk & Albert Jan van Hoek & Jelle Koopsen & Robert A de Man & Marie-Josee J Mangen & Hester E de Melker & Johan J Polder & G Ardine de Wit & Irene K Veldhuijzen, 2018. "Cost-effectiveness of screening for chronic hepatitis B and C among migrant populations in a low endemic country," PLOS ONE, Public Library of Science, vol. 13(11), pages 1-16, November.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Salas-Vega, Sebastian & Shearer, Emily & Mossialos, Elias, 2020. "Relationship between costs and clinical benefits of new cancer medicines in Australia, France, the UK, and the US," Social Science & Medicine, Elsevier, vol. 258(C).
    2. Mickaël Hiligsmann & Stuart S. Silverman & Andrea J. Singer & Leny Pearman & Jake Mathew & Yamei Wang & John Caminis & Jean-Yves Reginster, 2023. "Cost-Effectiveness of Sequential Abaloparatide/Alendronate in Men at High Risk of Fractures in the United States," PharmacoEconomics, Springer, vol. 41(7), pages 819-830, July.
    3. Aris Angelis & Huseyin Naci & Allan Hackshaw, 2020. "Recalibrating Health Technology Assessment Methods for Cell and Gene Therapies," PharmacoEconomics, Springer, vol. 38(12), pages 1297-1308, December.
    4. Joost W. Geenen & Cornelis Boersma & Olaf H. Klungel & Anke M. Hövels, 2019. "Accuracy of budget impact estimations and impact on patient access: a hepatitis C case study," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(6), pages 857-867, August.
    5. Ara, R & Brazier, JE, 2010. "Using health state utility values from the general population to approximate baselines in decision analytic models when condition specific data are not available," MPRA Paper 29946, University Library of Munich, Germany.
    6. Malek Ebadi & Raha Akhavan-Tabatabaei, 2021. "Personalized Cotesting Policies for Cervical Cancer Screening: A POMDP Approach," Mathematics, MDPI, vol. 9(6), pages 1-20, March.
    7. Sabine Vogler, 2019. "Fair prices for medicines? Exploring competent authorities’ and public payers’ preferences on pharmaceutical policies," Empirica, Springer;Austrian Institute for Economic Research;Austrian Economic Association, vol. 46(3), pages 443-469, August.
    8. Jae Ho Jung & Dae Jung Kim & Kangho Suh & Jaeeun You & Je Ho Lee & Kyung In Joung & Dong Churl Suh, 2021. "International Price Comparisons of Anticancer Drugs: A Scheme for Improving Patient Accessibility," IJERPH, MDPI, vol. 18(2), pages 1-14, January.
    9. Sarah Garner & Andrew Rintoul & Suzanne R. Hill, 2018. "Value-Based Pricing: L’Enfant Terrible?," PharmacoEconomics, Springer, vol. 36(1), pages 5-6, January.
    10. Lin Li & J L (Hans) Severens & Olena Mandrik, 2019. "Disutility associated with cancer screening programs: A systematic review," PLOS ONE, Public Library of Science, vol. 14(7), pages 1-17, July.
    11. Peter Lindgren & Sofia Löfvendahl & Gunnar Brådvik & Ola Weiland & Bengt Jönsson, 2022. "Value appropriation in hepatitis C," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(6), pages 1059-1070, August.
    12. Prajakta P. Masurkar & Haluk Damgacioglu & Ashish A. Deshmukh & Meghana V. Trivedi, 2023. "Cost Effectiveness of CDK4/6 Inhibitors in the First-Line Treatment of HR+/HER2− Metastatic Breast Cancer in Postmenopausal Women in the USA," PharmacoEconomics, Springer, vol. 41(6), pages 709-718, June.
    13. Shu‐Mei Tsai & Jung‐Ta Kao & Yun‐Fang Tsai, 2019. "Illness trajectory of initial infection for patients with hepatitis C: A qualitative study," Nursing & Health Sciences, John Wiley & Sons, vol. 21(1), pages 112-118, March.
    14. Lisa J McGarry & Girishanthy Krishnarajah & Gregory Hill & Michelle Skornicki & Narin Pruttivarasin & Cristina Masseria & Bhakti Arondekar & Stephen I Pelton & Milton C Weinstein, 2013. "Cost-Effectiveness Analysis of Tdap in the Prevention of Pertussis in the Elderly," PLOS ONE, Public Library of Science, vol. 8(9), pages 1-9, September.
    15. Amber Pearson & Gregory Breetzke, 2014. "The Association Between the Fear of Crime, and Mental and Physical Wellbeing in New Zealand," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 119(1), pages 281-294, October.
    16. David Beheshti, 2019. "Adverse health effects of abuse‐deterrent opioids: Evidence from the reformulation of OxyContin," Health Economics, John Wiley & Sons, Ltd., vol. 28(12), pages 1449-1461, December.
    17. Roediger, Alexander & Wilsdon, Tim & Haderi, Artes & Pendleton, Kathy & Azais, Boris, 2019. "Competition between on-patent medicines in Europe," Health Policy, Elsevier, vol. 123(7), pages 652-660.
    18. James K. Hammitt, 2017. "Valuing Non-Fatal Health Risks: Monetary and Health-Utility Measures," Revue économique, Presses de Sciences-Po, vol. 68(3), pages 335-356.
    19. Andrea C Villanti & Yiding Jiang & David B Abrams & Bruce S Pyenson, 2013. "A Cost-Utility Analysis of Lung Cancer Screening and the Additional Benefits of Incorporating Smoking Cessation Interventions," PLOS ONE, Public Library of Science, vol. 8(8), pages 1-11, August.
    20. Mehmet A. Ergun & Ali Hajjar & Oguzhan Alagoz & Murtuza Rampurwala, 2022. "Optimal breast cancer risk reduction policies tailored to personal risk level," Health Care Management Science, Springer, vol. 25(3), pages 363-388, September.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0176503. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.