PREDICTING THE IMPACT OF ADVERSE EVENTS AND TREATMENT DURATION ON MEDICAL RESOURCE UTILISATION RELATED COSTS IN HEPATITIS C GENOTYPE 1 TREATMENT-NAÏVE PATIENTS RECEIVING ANTIVIRAL THERAPY
Author(s)
Akpo H1, Cerri K2, Sbarigia U3, Kleintjens J4
1Deloitte, Diegem, Belgium, 2Janssen Pharmaceutica NV, Beerse, Belgium, 3Janssen Global Services, Beerse, Belgium, 4London School of Economics and Political Science, London, UK
OBJECTIVES Studies on medical resource utilization (MRU) and related costs are important for evaluating the potential patient management and cost-effectiveness implications of antiviral treatments for Hepatitis C virus (HCV) infection. The objectives of this study were (i) to compare the MRU and related costs for two treatment approaches, (ii) to identify the main drivers of resource use and costs, and (iii) to assess the effect of various treatment regimen attributes on MRU-related costs in a UK clinical setting. METHODS The analysis used data collected alongside the simeprevir (SMV) phase III trials for treatment-naïve genotype 1 HCV-infected patients; these data covered outpatient consultations with specialists, emergency room visits and hospital admissions. Logistic regressions were constructed to estimate the predictors for resource utilization, and a two-part multivariable analysis model was used to determine the total costs of treatment in the UK. RESULTS Data on 731 patients receiving SMV with pegylated interferon and ribavirin (PegIFN/R) or PegIFN/R alone were included in the analysis. While MRU was similar between SMV and PegIFN/R groups, MRU-related costs were significantly lower in the SMV group, compared to the PegIFN/R group (P<0.05). High body mass index (P<0.05), severe fibrosis (P<0.05), shortened treatment duration from 48 to 24 weeks (P<0.05), anaemia and rash during treatment (P<0.001) were identified as predictors of hospitalisation and outpatient visits and as drivers of total costs. Univariate sensitivity analyses demonstrated that shortened treatment duration and lower occurrence of rash lead to large cost savings. CONCLUSIONS This study identified both baseline and on-treatment antiviral therapy characteristics as drivers of MRU-related costs for HCV patients following antiviral therapy. The shortened treatment duration and reduction in adverse events due to simeprevir treatment lead to extra cost savings compared with PegIFN/R treatment. This suggests that there are potential patient management and cost-effectiveness implications associated with the choice of specific antiviral treatments.
Conference/Value in Health Info
2014-11, ISPOR Europe 2014, Amsterdam, The Netherlands
Value in Health, Vol. 17, No. 7 (November 2014)
Code
PIN96
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Infectious Disease (non-vaccine)