Economic evaluation of Zepatier for the management of HCV in the Italian scenario

Background Hepatitis virus (HCV) is a major health issue worldwide. New generation of direct-active antiviral medications is an epoch-making turning point in the management of HCV infections. Objective Conducing a cost-effectiveness analysis comparing the combination of elbasvir/grazoprevir and sofo...

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Bibliographic Details
Published in:The European journal of health economics 2018-12, Vol.19 (9), p.1365-1374
Main Authors: Rolli, F. R., Ruggeri, M., Kheiraoui, F., Drago, C., Basile, M., Favaretti, C., Cicchetti, A.
Format: Article
Language:English
Subjects:
Antiviral Agents - economics
Benzofurans - economics
Benzofurans - therapeutic use
Cost analysis
Cost of Illness
Cost-Benefit Analysis
Drug Combinations
Economic Policy
Expenditures
Health Care Management
Health Economics
Hepacivirus
Hepatitis
Hepatitis C
Hepatitis C - drug therapy
Hepatitis C - economics
Humans
Imidazoles - economics
Imidazoles - therapeutic use
Interferon
Interferons - economics
Interferons - therapeutic use
Italy
Markov analysis
Markov Chains
Medicine
Medicine & Public Health
Original Paper
Pharmacoeconomics and Health Outcomes
Public Finance
Public Health
Quality-Adjusted Life Years
Quinoxalines - economics
Quinoxalines - therapeutic use
Ribavirin - economics
Ribavirin - therapeutic use
Sofosbuvir - economics
Sofosbuvir - therapeutic use
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Summary:Background Hepatitis virus (HCV) is a major health issue worldwide. New generation of direct-active antiviral medications is an epoch-making turning point in the management of HCV infections. Objective Conducing a cost-effectiveness analysis comparing the combination of elbasvir/grazoprevir and sofosbuvir-hpegylated interferon/ribavirin for the management of all HCV patients (even those in the initial stages of fibrosis). Methods A Markov model was built on the natural history of the disease to assess the efficacy of the alternatives. The outcomes are expressed in terms of quality adjusted life-years (QALYs) and result in terms of incremental cost-effectiveness ratio). Results Elbasvir/grazoprevir implies an expenditure of €21,104,253.74 with a gain of 19,287.90 QALYs and sofosbuvir + pegylated interferon/ribavirin implies an expenditure of €31,904,410.11 with a gain of 18,855.96 QALYs. Elbasvir/ grazoprevir is thus a dominant strategy. Conclusion Consideration should be given to the opportunity cost of not treating patients with a lower degree of fibrosis (F0-F2).
ISSN:1618-7598
1618-7601
DOI:10.1007/s10198-018-0980-4