COST-EFFECTIVENESS OF TELAPREVIR IN GENOTYPE 1 CHRONIC HEPATITIS C VIRUS (HCV) INFECTION IN ARGENTINA
Author(s)
Garcia Marti S*1;Alcaraz A1;Valanzasca P1;Garay Ulises U1;McMullen M1;Rey Ares L1;Peirano I2;Bessone F3;Fainboim H4;Gadano A5;Galdame O5;Vujacich C6, Caporale J1 1Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina, 2Jan
OBJECTIVES: Direct acting antiviral therapies (DAA) in addition to PEG 2a + RBV (PR) are a new therapeutic option with higher rates of sustained virological response (SVR) than dual therapy (PR) alone in chronic hepatitis C. Currently, two alternatives of DAA, telaprevir (TVR) and boceprevir (BOC), are available in Argentina. The aim of this study was to evaluate the cost-effectiveness of adding TVR to PR in treatment naive and previously treated patients with HCV in Argentina compared to PR alone and with the addition of BOC. METHODS: A lifetime Markov model was developed including HCV, cirrhosis, liver transplant and death as health states. QALYs as an outcome measure, a private health subsector perspective and a 5% discount rate for health benefits and costs have been used. Costs are expressed in local currency. A review of the literature to obtain epidemiologic and resources utilization data was performed and when data were not available or validation was needed a Delphi panel with local experts was carried out. Deterministic and probabilistic sensitivity analysis was performed. RESULTS: In comparison with PR, TVR avoided 166 cirrhosis cases and 13 deaths per 1,000 patients and shown an ICER of $141,922/QALY and $74,332/QALY for the naïve and for the previously treated patients respectively. TVR presented extended dominance (lower ICER) against BOC in naïve patients and complete dominance (less costly and more efficacious) in most of the previously treated ones, except in the partial responders subgroup. Against the WHO criteria TVP versus PR presented a 42% of probability of being cost effective for naïve and 75% of probability of being cost effective for previously treated patients. CONCLUSIONS: TVR dominated BOC and its ICER against double therapy was slightly above WHO 3x GDP criteria in Argentina from a private subsector perspective.
Conference/Value in Health Info
2013-09, ISPOR Latin America 2013, Buenos Aires, Argentina
Value in Health, Vol. 16, No. 7 (November 2013)
Code
PGI2
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Gastrointestinal Disorders