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Economic Evaluation of Direct-Acting Antivirals for Hepatitis C in Norway

Author

Listed:
  • Torbjørn Wisløff

    (Norwegian Institute of Public Health
    University of Oslo)

  • Richard White

    (Norwegian Institute of Public Health)

  • Olav Dalgard

    (Akershus University Hospital
    University of Oslo)

  • Ellen J. Amundsen

    (Norwegian Institute of Public Health)

  • Hinta Meijerink

    (Norwegian Institute of Public Health)

  • Astrid Louise Løvlie

    (Norwegian Institute of Public Health)

  • Hilde Kløvstad

    (Norwegian Institute of Public Health)

Abstract

Purpose New direct-acting antiviral (DAA) drugs have revolutionized the treatment of hepatitis C in recent years. Objective Our objective was to analyse the cost effectiveness of combinations of different DAAs compared with ribavirin and peginterferon-α-2a, taking into account rebates from tender negotiations. Methods We used a compartmental model specifically developed for Norway to simulate hepatitis C and complications with and without different DAAs. All costs were based on Norwegian fees and estimates, estimating healthcare sector costs for the year 2016. We performed Monte Carlo simulations on uncertain input parameters to facilitate probabilistic sensitivity analyses. Results For patients diagnosed with genotype 1, the combination of paritaprevir, ritonavir, ombitasvir and dasabuvir was cost effective compared with eight other available alternatives, given a cost-effectiveness threshold of €70,000 per quality-adjusted life-year. For genotype 2, the combination of sofosbuvir and ribavirin was the most effective and cost-effective alternative for all patients. Among available alternatives for patients with genotype 3, sofosbuvir in combination with peginterferon and ribavirin was the most cost-effective alternative, although the combination of daclatasvir and sofosbuvir was somewhat more effective. Conclusions For each of the hepatitis C genotypes 1, 2 and 3, there were combinations of DAAs that were cost effective in a Norwegian setting. As a result of recent tender negotiations in Norway, treating all diagnosed patients with hepatitis C with the most cost-effective DAAs will result in lower total expenditure on these medications compared with 2015.

Suggested Citation

  • Torbjørn Wisløff & Richard White & Olav Dalgard & Ellen J. Amundsen & Hinta Meijerink & Astrid Louise Løvlie & Hilde Kløvstad, 2018. "Economic Evaluation of Direct-Acting Antivirals for Hepatitis C in Norway," PharmacoEconomics, Springer, vol. 36(5), pages 591-601, May.
    • Handle: RePEc:spr:pharme:v:36:y:2018:i:5:d:10.1007_s40273-017-0604-3
    DOI: 10.1007/s40273-017-0604-3
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    References listed on IDEAS

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    1. Beth Woods & Rita Faria & Susan Griffin, 2016. "Assessing the Value of New Treatments for Hepatitis C: Are International Decision Makers Getting this Right?," PharmacoEconomics, Springer, vol. 34(5), pages 427-433, May.
    2. Briggs, Andrew & Sculpher, Mark & Claxton, Karl, 2006. "Decision Modelling for Health Economic Evaluation," OUP Catalogue, Oxford University Press, number 9780198526629.
    3. Drummond, Michael F. & Sculpher, Mark J. & Claxton, Karl & Stoddart, Greg L. & Torrance, George W., 2015. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 4, number 9780199665884.
    4. Elisabeth Fenwick & Karl Claxton & Mark Sculpher, 2001. "Representing uncertainty: the role of cost‐effectiveness acceptability curves," Health Economics, John Wiley & Sons, Ltd., vol. 10(8), pages 779-787, December.
    5. Beth Woods & Paul Revill & Mark Sculpher & Karl Claxton, 2015. "Country-level cost-effectiveness thresholds: initial estimates and the need for further research," Working Papers 109cherp, Centre for Health Economics, University of York.
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