OUTCOMES AND COSTS OF TREATING HEPATITIS C WITH DIRECT-ACTING ANTIVIRALS- RESULTS FROM THE GERMAN HEPATITIS C-REGISTRY
Author(s)
Krauth C1, Krüger K1, Rossol S2, Mauss S3, Boeker KH4, Schott E5, Klinker H6, Pathil A7, Heyne R8, Stahmeyer JT1
1Hannover Medical School, Hannover, Germany, 2Krankenhaus Nordwest, Frankfurt a.M., Germany, 3Center for HIV and Hepatogastroenterology, Düsseldorf, Germany, 4Leberpraxis Hannover, Hannover, Germany, 5Charité Universitätsmedizin Berlin, Berlin, Germany, 6University Hospital Würzburg, Würzburg, Germany, 7University Clinic of Heidelberg, Heidelberg, Germany, 8Leberzentrum am Checkpoint, Berlin, Germany
OBJECTIVES: Chronic HCV infection is associated with a significant health burden. Long-term consequences are the development of liver cirrhosis and hepatocellular carcinoma. The introduction of direct-acting antivirals (DAAs) has dramatically changed hepatitis C treatment and sustained virologic response rates (SVR) of >90% were observed in clinical trials. Especially interferon-free regimens allow a shorter treatment duration and show favorable toxicity profile. Nevertheless new treatment options were accompanied with higher pharmaceutical costs. The aim of the current study was to analyze outcomes and treatment costs in a real-world setting. METHODS: Data were derived from the German Hepatitis C-Registry (DHC-R). The DHC-R is a prospective, multicenter real-world registry study comprising approximately 10,500 patients. Patients are treated at the discretion of the physician. This analysis included all patients with HCV genotype (GT) 1 and 3 who initiated and finished treatment between 02/2014 and 02/2017 and were documented in the pharmacoeconomic substudy. RESULTS: A total of 2,673 patients receiving antiviral treatment were analyzed; 88.0% had GT-1 and 12.0% GT-3 infection. Mean age was 54.6 years, 52.3% were male. Estimated mean duration of infection was 20.6 years. About half of the population (48.1%) was treatment-naïve and 30.2% had liver cirrhosis. 93.5% of all patients achieved SVR (GT-1: 94.0%, GT-3: 89.1%). Average total treatment costs were €67,979 (€67,131 pharmaceutical costs, €824 ambulatory care, €24 hospital costs). Treatment costs were considerably lower in GT-1 compared to GT-3 patients (€65,650 vs. €85,039). Average costs per SVR (cure) of €69,841 for GT-1 and €95,443 for GT-3 were calculated. CONCLUSIONS: This analysis confirms high SVR rates for newly introduced DAAs in a real-world setting. Although costs for antiviral treatment have further increased, costs per SVR estimated are comparable to first generation DAAs. Detailed analyses stratified by treatment status, degree of cirrhosis and regimen should follow.
Conference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PIN43
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Infectious Disease (non-vaccine)