Value in Hepatitis C Virus Treatment: A Patient-Centered Cost-Effectiveness Analysis
MetadataShow full item record
AbstractBackground: Innovations in hepatitis C virus (HCV) therapy included in traditional comparative evaluations focus on sustained virologic response (SVR) without addressing challenges patients report beyond virologic cure. This study aims to evaluate the cost-effectiveness of HCV drug therapy with a patient-centered approach. Methods: An individual-based Markov model was constructed using guidance from a stakeholder advisory board (SAB), a patient Delphi panel, and published literature to evaluate direct-acting antivirals (DAAs) compared to no treatment. The United States (US) health sector and societal perspectives were considered for 10- and 20-year time horizons. Inputs for treatment costs and effectiveness reflect a generic regimen. Indirect costs used for the societal model included estimates from self-reported productivity in a matched-control sample. Beyond the traditional quality-adjusted life-year (QALY) health outcome, this study included two novel measures developed from the Delphi panel and SAB: infected life-years and workdays missed. All costs were measured in 2018 US dollars. Results: Health sector costs and QALYs were higher in the treatment group in both 10- and 20-year models. Total infected life-years and workdays missed were reduced in the treatment group for both models. When costs of absenteeism, presenteeism, and patient/caregiver time were included, the DAA intervention was cost-saving at both 10 and 20 years. Health sector results were sensitive to drug costs and utility estimates for post-SVR health states. Societal results were sensitive to presenteeism estimates and drug costs. Conclusion: Treatment was cost-effective from a health sector perspective and cost-saving when including non-health costs such as patient/caregiver time and productivity. Copyright 2019, The Author(s).
SponsorsPatient-Centered Outcomes Research Institute: 7709720-A; National Health and Medical Research Council; Takeda Pharmaceuticals North America; Novartis Pharmaceuticals Corporation; Pfizer; Pharmaceutical Research and Manufacturers of America Foundation.
Identifier to cite or link to this itemhttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85076764805&doi=10.1007%2fs40273-019-00864-8&partnerID=40&md5=ec2acb1b56d673e456eba333de90bd76; http://hdl.handle.net/10713/11558
- Cost-effectiveness of hepatitis C treatment using generic direct-acting antivirals available in India.
- Authors: Aggarwal R, Chen Q, Goel A, Seguy N, Pendse R, Ayer T, Chhatwal J
- Issue date: 2017
- Peginterferon alfa and ribavirin for chronic hepatitis C in patients eligible for shortened treatment, re-treatment or in HCV/HIV co-infection: a systematic review and economic evaluation.
- Authors: Hartwell D, Jones J, Baxter L, Shepherd J
- Issue date: 2011 Apr
- Assessment of cost of innovation versus the value of health gains associated with treatment of chronic hepatitis C in the United States: The quality-adjusted cost of care.
- Authors: Younossi ZM, Park H, Dieterich D, Saab S, Ahmed A, Gordon SC
- Issue date: 2016 Oct
- A clinician's guide to the cost and health benefits of hepatitis C cure assessed from the individual patient perspective.
- Authors: McEwan P, Selvapatt N, Brown A, Thursz M, Bennett H, Webster S, Kalsekar A, Yuan Y, Brenner M, Gordon J
- Issue date: 2017 Feb
- Cost-effectiveness of generic pan-genotypic sofosbuvir/velpatasvir versus genotype-dependent direct-acting antivirals for hepatitis C treatment.
- Authors: Goel A, Chen Q, Chhatwal J, Aggarwal R
- Issue date: 2018 Dec