Published Oct 8, 2013

Pittsburgh, PA, USA - Around 3 million people in the United States are chronically infected with hepatitis C virus (HCV), which is the leading cause of liver cancer and liver transplant. Unlike hepatitis A and B, no vaccine is currently available for hepatitis C. After a gap of 10 years, boceprevir, belonging to the class of protease inhibitors, was approved for HCV treatment in 2011. The new treatment increased the cure rates, however, it is expensive and has several side effects. The cost-effectiveness of treating patients with boceprevir who failed prior treatment is not known in the U.S. A team of researchers (including health economists and hepatologists) from the University of Pittsburgh and Merck developed a Markov state-transition model simulating the clinical trials and the natural history of hepatitis C disease. Using this model, the researchers determined that boceprevir-based treatment was cost-effective in treating HCV-infected patients who failed prior treatment, irrespective of prior treatment response, disease stage and genetic profile. Their findings showed that boceprevir-based treatment is expected to increase the quality-adjusted life years (QALY) by 0.85-1.01 years. In addition, the new treatment can reduce the lifetime incidence of decompensated cirrhosis, liver cancer, liver-transplant and liver-related death by 41-52% in comparison with the peginterferon-ribavirin. At the average drug cost of $53,000, the incremental cost-effectiveness ratio of new treatment compared to the standard of care was $35,000 per QALY in early stages of disease and $10,000 per QALY in cirrhosis stage. Jagpreet Chhatwal, PhD, now an Assistant Professor of Health Services Research at The University of Texas MD Anderson Cancer Center in Houston, and the lead-author of the study said, “We developed a modeling framework that incorporates data from clinical trials, natural history of hepatitis C disease, costs, and quality of life to evaluate the cost-effectiveness of new treatment regimens. The new treatment, although expensive, can reduce the downstream costs associated with liver transplant and liver cancers, and improve the length and quality of life of the patients.”  The full study, “Cost-Effectiveness of Boceprevir in Patients Previously Treated for Chronic Hepatitis C Genotype I Infection in the United States” is published in Value in Health.

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