F R Rolli1, M Ruggeri1, F Kheiraoui2,3, C Drago4, M Basile5, C Favaretti3, A Cicchetti1. 1. Catholic University of Sacred Heart, Largo Francesco Vito 1, 00186, Rome, Italy. 2. Istituto di Sanità Pubblica, Sezione Igiene, Catholic University of Sacred Heart, Rome, Italy. 3. VIHTALI, Value in Health Technology and Academy for Leadership and Innovation Spin-Off of the Catholic University of Sacred Heart, Rome, Italy. 4. "Nicolò Cusano" University, Rome, Italy. 5. Catholic University of Sacred Heart, Largo Francesco Vito 1, 00186, Rome, Italy. michele.basile@unicatt.it.
Abstract
BACKGROUND: Hepatitis C 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 + pegylated 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).
BACKGROUND:Hepatitis C 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 + pegylated interferon/ribavirin for the management of all HCVpatients (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).
Authors: Andrew H Briggs; Milton C Weinstein; Elisabeth A L Fenwick; Jonathan Karnon; Mark J Sculpher; A David Paltiel Journal: Value Health Date: 2012 Sep-Oct Impact factor: 5.725
Authors: Timothy R Morgan; Marc G Ghany; Hae-Young Kim; Kristin K Snow; Mitchell L Shiffman; Jennifer L De Santo; William M Lee; Adrian M Di Bisceglie; Herbert L Bonkovsky; Jules L Dienstag; Chihiro Morishima; Karen L Lindsay; Anna S F Lok Journal: Hepatology Date: 2010-09 Impact factor: 17.425
Authors: Jules L Dienstag; Marc G Ghany; Timothy R Morgan; Adrian M Di Bisceglie; Herbert L Bonkovsky; Hae-Young Kim; Leonard B Seeff; Gyongyi Szabo; Elizabeth C Wright; Richard K Sterling; Gregory T Everson; Karen L Lindsay; William M Lee; Anna S Lok; Chihiro Morishima; Anne M Stoddard; James E Everhart Journal: Hepatology Date: 2011-06-23 Impact factor: 17.425