OBJECTIVES: Treatment options for patients infected with Hepatitis C (HCV) with Genotype 2 and 3 are limited compared with other genotypes. The objective of this study was to conduct a cost-effectiveness analysis of genotype 2 and 3 Direct Antiviral Agents (DAA) treatments in Mexico.

METHODS: The study design was a cost-effectiveness analysis from the Mexican health system perspective. Prices of DAA and medical costs were obtained from a governmental (public) source and expressed in 2018 USD. A previously published Markov model considering Fibrosis (F0-F4), hepatocellular carcinoma, decompensated cirrhosis, liver transplant and death was used. The two efficacy outcomes were Sustained Virological Response 12 weeks after the end of treatment (SVR12) and Years Life Gained Results were presented as Incremental Cost-Effectiveness Ratio (ICER). A discount rate of 3% was used and a probabilistic sensitivity analysis (PSA) was conducted.

RESULTS: Sofosbuvir 400mg/Velpatasvir 100mg is a dominant option for both, genotype 2 and 3, compared with other DAA treatments as Sofosbuvir + Ribavirin, Sofosbuvir + Daclatasvir. Efficacy for Sofosbuvir 400mg/Velpatasvir 100mg was higher and treatment costs lower in all comparisons versus other DAA in both efficacy outcomes, SVR12 and LYG. The PSA showed robustness of results, variations of ±10% in costs did not change the results.

CONCLUSIONS: Patients infected with HCV genotype 2 and 3 have limited treatment options. Sofosbuvir 400mg/Velpatasvir 100mg showed to be a cost-saving option for the Mexican health system compared with available options.