OBJECTIVES: The purpose of this study was to estimate the cost-effectiveness of ravidasvir plus sofosbuvir versus the standard-of-care (pegylated interferon plus ribavirin) for treating chronic hepatitis C with genotypes 1 and 6 patients in Thailand.

METHODS: A cost-effectiveness analysis using a model-based economic evaluation was conducted based on a societal perspective using data specific to the Thai population. A Markov model evaluated chronic hepatitis C genotype 1 and 6 between the standard-of-care treatment of pegylated interferon plus ribavirin for 24 weeks and ravidasvir plus sofosbuvir for 24 weeks. The results were presented as incremental cost-effectiveness ratios (ICERs) in 2022 US dollars (USD) per quality-adjusted life year (QALY) gained. The willingness-to-pay (WTP) threshold of 5,000 USD/QALY (160,000 THB/QALY) was used to determine whether the option was cost-effective. The transitional probabilities between health states, efficacies of the drug combination, costs of each treatment regimen, and the utility values of patients with chronic HCV infection and complications were obtained from previously published literature. All costs were converted into 2022 values by using the Thai consumer price index (CPI) and discounted at a rate of 3%. The exchange rate of THB to 1 USD was 36 Baht. A base-case analysis was performed, including the one-way sensitivity analysis and probabilistic sensitivity analysis (PSA), to determine the uncertainty of parameters.

RESULTS: For the base-case analysis, the ravidasvir plus sofosbuvir treatment provided an ICER of -2,776 USD/QALY with a lower cost (2,009 vs. 15,128 USD) and higher effectiveness (26.349 vs. 21.623 QALYs) compared to the standard-of-care treatment, including a cost saving of 13,119 USD. Sensitivity analysis showed the cost of chronic HCV was found to impact the ICER the most but did not change the decision.

CONCLUSIONS: HCV treatment with ravidasvir plus sofosbuvir was dominant or cost-saving in Thailand compared to the standard-of-care treatment.