COST/EFFECTIVENESS ANALYSIS OF DIRECT-ACTING ANTIVIRALS FOR HEPATITIS C VIRUS IN TREATMENT-NAIVE GENOTYPE 1 WITHOUT CIRRHOSIS PATIENTS IN SPANISH POPULATION
Author(s)
Margusino Framiñan L, Castro-Iglesias A, Mena-de-Cea A, Cid-Silva P, Rodriguez-Osorio I, Pernas-Souto B, Martin-Herranz I
A CORUÑA HOSPITAL, A CORUÑA, Spain
Presentation Documents
OBJECTIVES. Daily-fixed-dose antiviral regimens evidence/recommended rated “I,A” for treatment-naive genotype 1 patients without cirrhosis (TN-G1a-NC) are: A-Glecaprevir(300 mg)/pibrentasvir(120 mg) 8 weeks; B-Elbasvir(50 mg)/grazoprevir(100 mg) for patients without baseline NS5A-RASsa for Elbasvir 12 weeks; C-Sofosbuvir(400 mg)/velpatasvir(100 mg) 12 weeks; D-Ledipasvir(90 mg)/sofosbuvir(400 mg) 12 weeks. The aim of this study to evaluate the cost/effectiveness of DAAs in TN-G1a-NC in Spanish population. METHODS. Cost/effectiveness analysis (CEA) from a Spanish Healthcare-System perspective. Effectiveness variable was sustained-virological response 12-weeks (SVR12), based on results of pivotal clinical trials. Due to high and similar safety profile and no need of analytical and medical follow-up during treatment, only drug-direct costs are considered. Results are expressed as Incremental Cost Effectiveness Ratio (ICER). First CEA compared all therapies and B was the case-base scenario to identify dominant therapies. Lastly, a sensitivity analysis was developed between dominant therapies, using the limits of the 95% confidence interval of SRV12 observed in pivotal trials. Data were analyzed by EPIDAT 3.1 software. RESULTS. ICER for therapy D vs B was €206391/SVR12, C vs D was € -278176/SVR12 and A vs C was € -120500/SVR12, so therapies C and A were selected as dominants. The sensitivity analysis A vs C (95%CI) revealed range between ICER € 4820000/SVR12 (lowest 95%CI value for A and highest for C) and ICER € -12684/SVR12 (lowest 95%CI for C and highest for A). CONCLUSIONS. From a Spanish Healthcare-System perspective, Glecaprevir(300 mg)/pibrentasvir(120 mg) 8 weeks is the most cost-effective therapy for TN-G1-NC followed by Sofosbuvir(400 mg)/velpatasvir(100 mg) 12 weeks. The main limitation of this study is that pivotal studies didn´t directly compare antiviral therapies, so some patient baseline characteristics could influence SRV12 effectiveness variable and CEA results in this population.
Conference/Value in Health Info
2018-05, ISPOR 2018, Baltimore, MD, USA
Value in Health, Vol. 21, S1 (May 2018)
Code
PGI20
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Gastrointestinal Disorders, Infectious Disease (non-vaccine)