OBJECTIVES: Chronic infection with hepatitis C virus (HCV) genotype 3 is associated with faster disease progression and is considered difficult to treat. The objective of this investigation was to compare the cost-effectiveness of two new all-oral, interferon-free treatment regimens: daclatasvir plus sofosbuvir (DCV+SOF) and sofosbuvir plus ribavirin (SOF+RBV). Historically, patients ineligible for/intolerant to interferon had no available treatment option; therefore, a comparison to no treatment was also made in these patients. METHODS: A published Markov model (MONARCH) was used to estimate the cost-effectiveness of treatment regimens over a lifetime horizon. Patients were evenly distributed across fibrosis stages F0–F4 upon treatment initiation. Patients progress through disease stages using published transition rates. Disease state costs were obtained from 2013 UK data, with discounting set to 3.5%. Weekly costs were: DCV=£2,043.15, SOF=£2,915.24 and RBV=£66.95. Clinical inputs were obtained from a matching-adjusted indirect comparison (adjusts for baseline differences between trials) of ALLY-3 and VALENCE: SVRs for DCV+SOF and SOF+RBV, respectively, were 96.4% and 94.3% for treatment-naïve, 83.2% and 78.6% for treatment-experienced and 88.8% and 85.2% for interferon-ineligible intolerant patients). RESULTS: In all comparisons, DCV+SOF was predicted to be associated with reduced total costs and improved QoL versus SOF+RBV:

• Treatment naïve: DCV+SOF expected to be associated with cost savings of £12,903 and QALY gains of 0.13.
• Treatment-experienced: DCV+SOF expected to be associated with cost savings of £13,701 and QALY gains of 0.24.
• Interferon-ineligible/intolerant: DCV+SOF expected to be associated with cost savings of £13,382 and QALY gains of 0.2.

Versus no treatment, DCV+SOF is expected to be cost-effective (total cost £31,875 and QALY gain of 4.12; ICER of £7,743) for interferon-ineligible/intolerant patients. CONCLUSIONS: