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Cost-Effectiveness Analysis of Early Treatment of Chronic HCV with Sofosbuvir/Velpatasvir in Italy


  • Matteo Ruggeri

    (Catholic University of Sacred Heart)

  • Federica Romano

    (Catholic University of Sacred Heart)

  • Michele Basile

    () (Catholic University of Sacred Heart)

  • Silvia Coretti

    (Catholic University of Sacred Heart)

  • Francesca Romana Rolli

    (Catholic University of Sacred Heart)

  • Carlo Drago

    (“Nicolò Cusano” University)

  • Americo Cicchetti

    (Catholic University of Sacred Heart)


Background Chronic Hepatitis C virus (cHCV) is a major health issue worldwide. New effective direct-acting anti-viral (DAA) drugs such as the combination sofosbuvir/velpatasvir, represent an important turning point, given the high sustained virologic response (SVR) rates associated with their use. Objectives To estimate the cost and effects of two different treatment strategies based on sofosbuvir/velpatasvir. Strategy 1: treating all patients, including those in the early stages of fibrosis; Strategy 2: reserving treatments for patients at more advanced stages of disease (≥ F3). The analysis compares the incremental cost-effectiveness ratio (ICER) of Strategy 1 versus Strategy 2 in a cohort of HCV-infected patients and a cohort of hepatitis C virus (HCV)-human immunodeficiency virus (HIV) patients. Methods A Markov model simulating the natural history of the disease was built considering a 60-year time horizon and two cohorts of 1000 patients aged ≥ 35 years. Disease morbidity was classified according to the METAVIR classification. The robustness of the model was tested using deterministic and probabilistic sensitivity analyses (PSA). Results In both cohorts, Strategy 1 results in higher resource consumption and a greater number of quality-adjusted life-years (QALYs) compared with Strategy 2. The ICERs for the cohort of HCV patients and the cohort of co-infected HCV/HIV patients ranged between €15,555–74,804/QALY and €10,708–55,138/QALY, respectively, depending on the assumed cost of the treatment. In the PSA, the ICER distribution remained below the threshold of €30,000/QALY in 96 and 97% of the scenarios in the cohorts of HCV and HCV/HIV patients, respectively. Conclusions Extending the treatment of HCV to patients at an early stage of HCV infection is estimated to be cost effective from the perspective of the Italian Healthcare System.

Suggested Citation

  • Matteo Ruggeri & Federica Romano & Michele Basile & Silvia Coretti & Francesca Romana Rolli & Carlo Drago & Americo Cicchetti, 2018. "Cost-Effectiveness Analysis of Early Treatment of Chronic HCV with Sofosbuvir/Velpatasvir in Italy," Applied Health Economics and Health Policy, Springer, vol. 16(5), pages 711-722, October.
  • Handle: RePEc:spr:aphecp:v:16:y:2018:i:5:d:10.1007_s40258-018-0410-x
    DOI: 10.1007/s40258-018-0410-x

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    References listed on IDEAS

    1. M. Ruggeri & M. Basile & S. Coretti & C. Drago & A. Cicchetti, 2017. "Economic Analysis and Budget Impact of Tenofovir and Entecavir in the First-Line Treatment of Hepatitis B Virus in Italy," Applied Health Economics and Health Policy, Springer, vol. 15(4), pages 479-490, August.
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    Cited by:

    1. Andrea Marcellusi & Raffaella Viti & Loreta A. Kondili & Stefano Rosato & Stefano Vella & Francesco Saverio Mennini, 2019. "Economic Consequences of Investing in Anti-HCV Antiviral Treatment from the Italian NHS Perspective: A Real-World-Based Analysis of PITER Data," PharmacoEconomics, Springer, vol. 37(2), pages 255-266, February.

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