This study compared the cost-effectiveness of direct-acting antiviral therapies currently recommended for treating genotypes (GT) 1 and 4 chronic hepatitis C (CHC) patients in the United States (US).
A cost-effectiveness analysis of treatments for CHC from a US payer’s perspective over a lifelong time horizon was performed. A Markov model based on the natural history of CHC was used for a population that included treatment-naïve and -experienced patients. Treatment alternatives considered for GT1 included ombitasvir/paritaprevir/ritonavir + dasabuvir ± ribavirin (3D±R), sofosbuvir + ledipasvir (SOF/LDV), sofosbuvir + simeprevir (SOF+SMV), simeprevir + pegylated interferon/ribavirin (SMV+PR), and no treatment (NT). For GT4 treatments were ombitasvir/paritaprevir/ritonavir + ribavirin (2D+R), SOF/LDV, and NT were compared. Transition probabilities, utilities, and costs were obtained from published literature. Outcomes included rates of compensated cirrhosis (CC), decompensated cirrhosis (DCC), hepatocellular carcinoma (HCC) and liver-related death (LrD), total costs, life-years, quality-adjusted life-years (QALYs). Costs and QALYs were used to calculate incremental cost-effectiveness ratios.
In GT1 patients, 3D±R and SOF-containing regimens have similar long term outcomes; 3D±R had the lowest lifetime risks of all liver disease outcomes: CC 30.2%, DCC 5.0%, HCC 6.8%, LT 1.9% and LrD 9.2%. In GT1 patients, 3D±R had the lowest cost and the highest QALYs. As a result, 3D±R dominated these treatment options. In GT4 patients, 2D+R had lower rates of liver morbidity and mortality, lower cost, and more QALYs than SOF/LDV and NT.
While the results are based on input values, which were obtained from a variety of heterogeneous sources – including clinical trials, the findings were robust across a plausible range of input values as demonstrated in probabilistic sensitivity analyses.
Among currently recommended treatments for GT1 and GT4 in the US, 3D±R (for GT1) and 2D+R (for GT4) have a favorable cost-effectiveness profile.

Schedule your 30 min Free 1stOncology Demo!
Discover why more than 1,500 members use 1stOncology™ to excel in:

Early/Late Stage Pipeline Development - Target Scouting - Clinical Biomarkers - Indication Selection & Expansion - BD&L Contacts - Conference Reports - Combinatorial Drug Settings - Companion Diagnostics - Drug Repositioning - First-in-class Analysis - Competitive Analysis - Deals & Licensing

                  Schedule Your 30 min Free Demo!