OBJECTIVES

: The study aims to analyse the impact of new DAAs for HCV management, before and after 2017, in Italy, not only on drugs costs, but considering the overall patients’ pathway expenditure.

METHODS

The economic evaluation considered the biennial cost of 578 HCV patients’ pathways (including diagnostic and laboratory examinations, hospitalizations and outpatients’ procedures), registered by three Italian Hospitals. Population was stratified depending on the antiviral drugs assumed i) before 2017, and ii) after 2017 (the year of the new HCV treatment criteria introduction in the Italian NHS), distinguishing also SOF-based regimens from the others.

Three scenarios were performed.

• Retrospective projection, considering the HCV pathways’ costs and drugs before 2017 and number of HCV population treated in the period 2015-2017 (887 patients).
• Hypothetical retrospective projection, considering the HCV pathways’ costs and drugs available after 2017, and number of HCV population treated in the period 2015-2017.
• Perspective projection, considering the HCV pathways’ costs and drugs before and after 2017, and the HCV population forecast treated in the period 2018-2020 (172.938 patients).

RESULTS

: Comparing the two retrospective projections, the HCV patients’ treatment expenditure decreased of -35%. If new treatments had been available since 2015, the economic saving would have been equal to 68,696,848€: about 630€ per patient. Results from perspective projection revealed that the savings are confirmed in the long term (about 500€ per patient, equal to -28%), despite the number of patients treated growth. In case of SOF-based regimens usage increase, additional 13% of savings would be registered.

CONCLUSIONS

: Results show new evidence concerning HCV pathway resources absorption, with a positive impact of SOF-based regimens. Since 2017, the increase in drugs expenditure was offset by a lower resource absorption per patient, assuring an efficient management of the overall HCV pathway (e.g. reduction of -63% in hospitalizations expenses).