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Cost-effectiveness analysis of the use of daclatasvir + sofosbuvir + ribavirin (16 weeks and 12 weeks) vs sofosbuvir + ribavirin (16 weeks and 24 weeks) for the treatment of cirrhotic patients affected with hepatitis C virus genotype 3 in Italy

Author

Listed:
  • Umberto Restelli

    (University of the Witwatersrand
    Centre for Research on Health Economics, Social and Health Care Management (CREMS)-LIUC-Carlo Cattaneo Univerity)

  • Alfredo Alberti

    (University of Padua)

  • Adriano Lazzarin

    (Università Vita-Salute San Raffaele)

  • Marzia Bonfanti

    (Centre for Research on Health Economics, Social and Health Care Management (CREMS)-LIUC-Carlo Cattaneo Univerity)

  • Carmela Nappi

    (Health Economic and Outcome Research Bristol Myers Squibb S.r.l.)

  • Davide Croce

    (University of the Witwatersrand
    Centre for Research on Health Economics, Social and Health Care Management (CREMS)-LIUC-Carlo Cattaneo Univerity)

Abstract

The WHO estimates that more than 185 million people are infected with hepatitis C virus (HCV) worldwide. The aim of the study is to assess the incremental cost-effectiveness ratio (ICER) of the use of daclatasvir (DCV) + sofosbuvir (SOF) + ribavirin (RBV) for 12 and 16 weeks vs SOF + RBV for 16 and 24 weeks for the treatment of genotype 3 HCV infected cirrhotic patients from the Italian National Health Service (NHS) perspective. A published cohort-based Markov model was used to perform the analysis estimating the lifetime direct medical costs associated with the management of the pathology and the quality adjusted life years gained by patients. Deterministic and probabilistic sensitivity analyses were performed to test the robustness of the results. SOF + RBV for 16 weeks was excluded from the analysis due to the significant lower effectiveness, compared with SOF + RBV for 24 weeks (51% vs 79%). DCV + SOF + RBV would increase QALYs and costs in all the comparisons: the ICERs obtained comparing DCV + SOF + RBV for 12 and 16 weeks with SOF + RBV for 24 weeks (reference scenario) are 38,572 €/QALY and 16,436 €/QALY, respectively, both below the 40,000 €/QALY threshold identified by the Italian Health Economics Association. Sensitivity analyses confirmed the robustness of the results. The use of DCV + SOF + RBV is likely to be cost-effective compared with SOF + RBV (for 24 weeks) for the treatment of cirrhotic patients infected with genotype 3 HCV considering a threshold value of 40,000 €/QALY.

Suggested Citation

  • Umberto Restelli & Alfredo Alberti & Adriano Lazzarin & Marzia Bonfanti & Carmela Nappi & Davide Croce, 2018. "Cost-effectiveness analysis of the use of daclatasvir + sofosbuvir + ribavirin (16 weeks and 12 weeks) vs sofosbuvir + ribavirin (16 weeks and 24 weeks) for the treatment of cirrhotic patients affecte," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(1), pages 37-44, January.
    • Handle: RePEc:spr:eujhec:v:19:y:2018:i:1:d:10.1007_s10198-016-0865-3
    DOI: 10.1007/s10198-016-0865-3
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    References listed on IDEAS

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    1. Phil McEwan & Ray Kim & Yong Yuan, 2013. "Assessing the Cost Utility of Response-Guided Therapy in Patients with Chronic Hepatitis C Genotype 1 in the UK Using the MONARCH Model," Applied Health Economics and Health Policy, Springer, vol. 11(1), pages 53-63, February.
    2. Francesco Saverio Mennini & Andrea Marcellusi & Massimo Andreoni & Antonio Gasbarrini & Salvatore Salomone & Antonio Craxì, 2014. "Health Policy Model: Long-term Predictive Results Associated With The Management Of HCV-Induced Diseases In Italy," CEIS Research Paper 308, Tor Vergata University, CEIS, revised 17 Feb 2014.
    3. Phil McEwan & Thomas Ward & Hayley Bennett & Anupama Kalsekar & Samantha Webster & Michael Brenner & Yong Yuan, 2015. "Estimating the Clinical and Economic Benefit Associated with Incremental Improvements in Sustained Virologic Response in Chronic Hepatitis C," PLOS ONE, Public Library of Science, vol. 10(1), pages 1-16, January.
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