OBJECTIVES: There are a huge number of treatment schemes for chronic hepatitis C virus with wide variety of effectiveness and cost, that make hard to choose best options while resources are limited. The aim of this study was to select the most optimal treatment regimens for chronic hepatitis C virus (HCV) genotypes 2 and 3 for reimbursement in Moscow in 2020 based on their comparative efficacy and costs per course.

METHODS: Treatment regimens were ranked based on their comparative efficacy and costs per course. Comparative efficacy was evaluated based on published network meta-analyses, as well as our own indirect comparisons. Prices for drugs were provided by the Moscow Healthcare Department. When determining the sub-groups of patients, the virus genotype, the presence or absence of treatment experience and liver cirrhosis were taken into account. List of comparators included pangenotypic and non-pangenotypic regimens, with the exception of regimens containing peginterferons.

RESULTS: Based on the results of the analysis, several recommended schemes were selected for each of the target sub-groups (due to the fact that the cost of the course of treatment and the efficacy of all top regimens were comparable):

In genotype 2 patients independent of subgroups top-3 regimens were: sofosbuvir+ribavirin (€ 3901 per course), daclatasvir+sofosbuvir±ribavirin (€ 5938 per course), velpatasvir+sofosbuvir (€ 6223 per course). The 4^th position in treatment-naïve cirrhotic and non-cirrhotic patients and treatment-experienced non-cirrhotic patients was glecaprevir+pibrentasvir (€ 6333 per course).

In genotype 3 patients independent of subgroups top-3 regimens were: daclatasvir+sofosbuvir±ribavirin (€ 5938 per course), velpatasvir+sofosbuvir (€ 6223 per course), sofosbuvir+ribavirin (€ 7803 per course). The 4th position in treatment-naïve cirrhotic and non-cirrhotic patients was glecaprevir+pibrentasvir (€ 6333 per course).

CONCLUSIONS: As a result of scientific-based analysis were selected treatment regimens for patients with chronic HCV genotypes 2 and 3 recommended for reimbursement in Moscow in 2020.