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Economic evaluation of Zepatier for the management of HCV in the Italian scenario


  • F. R. Rolli

    () (Catholic University of Sacred Heart)

  • M. Ruggeri

    () (Catholic University of Sacred Heart)

  • F. Kheiraoui

    () (Catholic University of Sacred Heart
    VIHTALI, Value in Health Technology and Academy for Leadership and Innovation Spin-Off of the Catholic University of Sacred Heart)

  • C. Drago

    () (“Nicolò Cusano” University)

  • M. Basile

    () (Catholic University of Sacred Heart)

  • C. Favaretti

    () (VIHTALI, Value in Health Technology and Academy for Leadership and Innovation Spin-Off of the Catholic University of Sacred Heart)

  • A. Cicchetti

    () (Catholic University of Sacred Heart)


Background Hepatitis C virus (HCV) is a major health issue worldwide. New generation of direct-active antiviral medications is an epoch-making turning point in the management of HCV infections. Objective Conducing a cost-effectiveness analysis comparing the combination of elbasvir/grazoprevir and sofosbuvir + pegylated interferon/ribavirin for the management of all HCV patients (even those in the initial stages of fibrosis). Methods A Markov model was built on the natural history of the disease to assess the efficacy of the alternatives. The outcomes are expressed in terms of quality adjusted life-years (QALYs) and result in terms of incremental cost-effectiveness ratio). Results Elbasvir/grazoprevir implies an expenditure of €21,104,253.74 with a gain of 19,287.90 QALYs and sofosbuvir + pegylated interferon/ribavirin implies an expenditure of €31,904,410.11 with a gain of 18,855.96 QALYs. Elbasvir/grazoprevir is thus a dominant strategy. Conclusion Consideration should be given to the opportunity cost of not treating patients with a lower degree of fibrosis (F0–F2).

Suggested Citation

  • F. R. Rolli & M. Ruggeri & F. Kheiraoui & C. Drago & M. Basile & C. Favaretti & A. Cicchetti, 2018. "Economic evaluation of Zepatier for the management of HCV in the Italian scenario," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(9), pages 1365-1374, December.
  • Handle: RePEc:spr:eujhec:v:19:y:2018:i:9:d:10.1007_s10198-018-0980-4
    DOI: 10.1007/s10198-018-0980-4

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    More about this item


    Cost-effectiveness analysis; ICER; Sensitivity analysis; Opportunity cost; HCV;

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health


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