Presentation (CTI)

OBJECTIVES: Hepatitis C virus (HCV) infection affects approximately 54 million people globally, with Asia bearing a disproportionate burden. This systematic review aimed to summarize the available evidence on the economic value of direct-acting antiviral (DAA) therapies for HCV infection across Asian countries, focusing on cost-effectiveness, cost-utility, budget impact, and other economic outcomes.
METHODS: A systematic literature review was conducted by following PRISMA guidelines. MEDLINE and Embase were searched for studies based on economic evaluations published between 2016 and 2025 conducted in Asian countries. Eligible study types included cost-effectiveness, cost-utility, budget impact, and model-based analyses. Data on study characteristics, interventions, modelling methods, and economic outcomes were extracted and summarized descriptively.
RESULTS: Thirty-six studies across eight Asian countries (China, Japan, India, Iran, Vietnam, Kazakhstan, South Korea, and Singapore) met inclusion criteria. Markov models were the predominant modelling approach, with most studies adopted healthcare payer or healthcare system perspectives. The interventions evaluated most frequently were sofosbuvir/velpatasvir, sofosbuvir/ledipasrevir, glecaprevir/pibrentasvir, and elbasvir/grazoprevir, compared with pegylated interferon/ribavirin, delayed treatment, or no treatment. Lifetime QALYs ranged from 15.0 to 16.3 among treatment-naïve, non-cirrhotic patients, and most studies reported ICERs below country-specific willingness-to-pay thresholds. Several analyses found DAA regimens to be dominant or cost-saving, primarily because of reductions in cirrhosis, hepatocellular carcinoma, liver transplantation, and liver-related mortality.
CONCLUSIONS: Available evidence showed that DAA therapies were consistently cost-effective or dominant for HCV treatment across Asian settings. Evidence from lower-income countries remains limited, highlighting the need for region-specific economic evaluations. Expanding DAA access through early diagnosis may improve health outcomes while supporting regional HCV elimination efforts.