OBJECTIVES: In recent years, direct-acting antivirals (DAAs) has been widely used and significantly improved the treatment effect, our purpose is to summary the cost-effectiveness in the treatment of chronic hepatitis C (CHC).

METHODS: A comprehensive literature retrieval from 2008 to 2018 was conducted through several electronic databases, including PubMed, Medline, CNKI and WANFANG, with CHC, pharmacoeconomics, economics evaluation, cost, and the corresponding drug names being the keywords.

RESULTS: Through screening, a total of 18 literatures were included, with 3 in Chinese and 15 in English. Available literatures mainly focused on genotype 1 patients, which included the comparisons between interferon and DAAs. Most studies adopted Markov state transition model, Cost-effectiveness analysis and cost-utility analysis were the most used. The study perspective usually was payers or governments, only including the direct medical cost. Just one study considered the indirect cost such as the loss of productivity. One-way sensitivity analysis and probabilistic sensitivity analysis were commonly used to deal with uncertainty. However, new methods have emerged. One study in Germany adopted multiple criteria decision analysis (MCDA) to establish the probabilistic efficiency frontier, and patient-relevant end points were identified and weighted by patients in a previous discrete-choice experiment (DCE).

CONCLUSIONS

: Some studies indicated that DAAs were cost-effective, and their cost-effectiveness depended on the cost, SVR (sustained viral response) rate, utility value and treatment stage. Future research should no longer be confined to the traditional ICERs. New methods such as MCDA and the probabilistic efficiency frontier should be used and indirect costs like the productivity loss need to be taken into account in order to further verify the cost-effectiveness of DAAs.