OBJECTIVES

: This study aims to evaluate the changes of cost for managing hepatitis C virus (HCV) patients after the introduction of sofosbuvir in Europe in 2014 and in the US in 2013.

METHODS

: A systematic review on HCV costs was conducted through Medline and Embase. Economic evaluations and observational studies evaluating the cost of managing HCV in Germany, France, the UK and the US were included. Total costs and sub cost-items including direct medical costs, direct non-medical costs and indirect costs were extracted. Mean costs evaluated before the introduction of sofosbuvir were directly compared with the mean costs after the introduction for each cost item.

RESULTS

: As the results of the screening of the 1,378 identified references, 11 economic models and 6 observational studies were included. In economic models, non-sofosbuvir-based regimens showed lower medical cost than sofosbuvir-based regimens: incremental costs were from €-1,560 to €-1,447 in Germany, €-32,423 in France, from €-19,129 to €-4,092 in the UK and from €-78,789 to €-2,059 in the US. In the French evaluation, non-sofosbuvir-based regimens showed lower costs in drug administration (€24,186 V.S. €67,291) but higher costs in other components (€23,772 V.S. €7,239). The included observational studies were conducted in Germany and the US. They showed that total costs for HCV increased after the introduction of sofosbuvir: the costs increased from €18,325 to €70,390 in Germany and from €69,581 to €128,389 in the US.

CONCLUSIONS

: The total costs of treating HCV increased after the introduction of sofosbuvir as shown in real world evidence, though sofosbuvir seems lower the non-drug costs for treating HCV patients from results of models. However, more real world evidence with detail cost and resource use for treating HCV are needed to understand the sofosbuvir impact in the changes of HCV management and its associated costs.