Cost‐effectiveness analyses of anti‐hepatitis C virus treatments using quality of life scoring among patients with chronic liver disease in Hiroshima prefecture, Japan

• Published in: Hepatology research 2018-06, Vol.48 (7), p.509-520
• Main Authors: Kaishima, Terumi, Akita, Tomoyuki, Ohisa, Masayuki, Sakamune, Kazuaki, Kurisu, Akemi, Sugiyama, Aya, Aikata, Hiroshi, Chayama, Kazuaki, Tanaka, Junko
• Format: Article
• Language: English
• Subjects: Age; Antiviral agents; Cirrhosis; cost‐effectiveness analysis; direct acting antiviral; EQ‐5D; Hepatitis; Hepatitis C; hepatitis C virus; Hepatocellular carcinoma; incremental cost‐effectiveness ratio; Interferon; Liver cirrhosis; Liver diseases; loss of productivity; Markov model; Patients; QALY; Quality of life; Ribavirin; Sensitivity analysis
• ISSN: 1386-6346; 1872-034X
• DOI: 10.1111/hepr.13053

Aim We estimated the cost‐effectiveness of direct‐acting antiviral treatment (DAA) compared to triple therapy (simeprevir, pegylated interferon‐α [Peg‐IFN], and ribavirin [RBV]) (scenario 1), Peg‐IFN + RBV (scenario 2), and non‐antiviral therapy (scenario 3). Methods Cost‐effectiveness was evaluated as incremental cost‐effectiveness ratios (ICERs) using direct costs and indirect costs, which included loss of wages during the patient's lifetime due to early death caused by viral hepatitis infection. Quality of life (QOL) scores were determined by EQ‐5D‐3L questionnaire survey on 200 HCV patients in Hiroshima. Results The QOL scores for chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma were estimated as 0.871, 0.774, and 0.780, respectively. The follow‐up period that the ICER of scenario 1 becomes shortest (cost