OBJECTIVES: Currently, 400-500 thousand people are suffering from Hepatitis C in Germany (62% genotype 1). Treatment of genotype 1 chronic Hepatitis C has been improved by recently approved new direct acting antivirals. Clinical studies showed a significant increase in sustained virological response rates from 38-46% to 63-79%. This study was to evaluate the cost-effectiveness of newly introduced triple therapy with Telaprevir (TVR+PR) compared to dual therapy (PR) for the treatment of genotype 1 hepatitis C virus (HCV) infection in previously untreated patients. METHODS: A previously published economic Markov model comparing triple therapy (TVR+PR) and dual therapy (PR) was adjusted for the German health care context (payer perspective). Effectiveness was measured on the basis of quality adjusted life years (QALY). Clinical outcomes and drug dosage were taken from the ADVANCE phase-3 trial. Other model parameters – including utilities - were adapted from German or if not available from international literature after an extensive literature search. Drug costs were taken from the German drug directory. All costs were inflated to the year 2012. A discount rate of 3% and a lifetime horizon were assumed. RESULTS: Base-case analysis shows that triple treatment (TVR+PR) compared with dual therapy (PR) results in higher costs (€49,378 vs. €30,743) and better outcomes (16.7 vs. 15.8 QALYs). The incremental costs per QALY gained were €21,277. Results were robust in multiple sensitivity analyses. Discount rate seemed to have major impact: a discount rate of 0% results in an ICER of 7,381 €/QALY, a discount rate of 5% in 34,694 €/QALY. CE acceptability curve shows a probability of an ICER below 30,000 €/QALY of more than 90%. CONCLUSIONS: Triple therapy with telaprevir for treatment-naïve HCV-genotype 1 patients is more effective than dual therapy, but results in higher costs (notably drug costs).