A SYSTEMATIC REVIEW OF ECONOMIC EVIDENCE IN HEPATITIS C- METHODS USED IN RECENT ECONOMIC EVALUATIONS

Author(s)

Woods MS*1;Kiri S2;Ling C1;McCrink L1;Zimovetz E1, Hass B3 1RTI Health Solutions, Manchester, United Kingdom, 2Boehringer Ingelheim Ltd, Bracknell, United Kingdom, 3Boehringer Ingelheim GmbH, Ingelheim, Germany

OBJECTIVES: To perform a systematic literature review of economic evidence for genotype 1 hepatitis C virus (HCV) treatments and to summarise and assess the methods used in recent economic evaluations. METHODS: Multiple databases were searched to identify economic evaluations in patients with genotype 1 HCV. Detailed review methods are presented elsewhere. RESULTS: 53 economic analyses and 17 Health Technology Assessment (HTA) documents were identified. Most economic analyses were performed using lifetime horizon Markov models, all for interferon-containing regimens. Most were performed in the United Kingdom (UK) (n = 13), United States (n = 13), or Germany (n = 7). Two recent National Institute for Health and Care Excellence (NICE) submissions were included: telaprevir triple therapy (with peginterferon plus ribavirin) and boceprevir triple therapy, for previously treated and untreated patients. The models used were different; however their structures and some inputs were based on previous NICE appraisals for peginterferon plus ribavirin. There were a number of limitations found in the included economic evaluations, which may have affected the cost-effectiveness outcomes: • The models did not adequately capture all health benefits and costs in their quality-adjusted life-year calculations. • The models did not account for the possibility of benefits caused by reduced transmission of HCV. • The models did not incorporate patient factors that may influence disease progression. • Modelling of subgroups may have been insufficient, particularly as the understanding of patient and viral factors that predict treatment response grows. • Some made generalisations for the compensated cirrhosis population that were not comparable with the UK population. CONCLUSIONS: Recent economic models have generally adhered to previous iterations of HCV models and have not evolved with our knowledge of the disease. In light of upcoming treatment alternatives, model refinement may be necessary to capture the increasingly complex treatment decisions that will be required.

Conference/Value in Health Info

2013-11, ISPOR Europe 2013, The Convention Centre Dublin

Value in Health, Vol. 16, No. 7 (November 2013)

Code

PRM25

Topic

Economic Evaluation

Topic Subcategory

Cost/Cost of Illness/Resource Use Studies

Disease

Infectious Disease (non-vaccine)

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