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Pharmacoeconomic analysis of sofosbuvir for the treatment of chronic hepatitis c (genotype 1) in the russian federation
The objectives of this study were to determine the most
advantageous antiviral therapy option for chronic hepatitis C (CHC)
(peginterferon alfa + ribavirin (PegIFN + RBV) 48 weeks (F0–F4), peginterferon
alfa + simeprevir + ribavirin (PegIFN + SMV + RBV) 24 weeks (F0–F4),
peginterferon alfa + sofosbuvir + ribavirin (PegIFN + SOF + RBV) 12 weeks
(F0–F4), dasabuvir + ombitasvir/paritaprevir/ritonavir (Dasabuvir + Ombitasvir/
paritaprevir/ritonavir) 12 weeks (F0–F3) and dasabuvir + ombitasvir/
paritaprevir/ritonavir + ribavirin (Dasabuvir + Ombitasvir/paritaprevir/ritonavir
+ RBV) 12 weeks (F4)) among treatment-naive and treatment-experienced
patients (HCV genotype 1) based on the comparison of cost-effectiveness
ratios and economic outcomes (“budget impact” analysis) from implementing
the treatment strategy PegIFN-α + SOF + RBV instead of PegIFN-α + RBV,
PegIFN-α + SIM + RBV and Dasabuvir + Ombitasvir/paritaprevir/ritonavir.
Model-based pharmacoeconomic analysis has been conducted. The costeffectiveness analysis showed that independently of the former treatment
experience of CHC (genotype 1) patients the combination PegIFN-α + SOF
+ RBV was a predominant regimen as compared to PegIFN-α + RBV and
PegIFN-α + SMV + RBV. In the groups of patients without cirrhosis and
with cirrhosis the highest QALY value was noted for Dasabuvir + Ombitasvir/
paritaprevir/ritonavir and Dasabuvir + Ombitasvir/paritaprevir/ritonavir + RBV
combinations, respectively. Also a smaller cost-effectiveness ratio (CER)
relative to the two above regimens was noted for PegIFN-α + SOF + RBV.
In the group of treatment-naive patients without cirrhosis incremental costeffectiveness ratio (ICER) of Dasabuvir + Ombitasvir/paritaprevir/ritonavir vs
PegIFN-α + SOF + RBV was higher than willingness-to-pay threshold (WPT),
whereas in the group of patients with cirrhosis ICERDasabuvir + Ombitasvir/paritaprevir/ritonavir
+ RBV vs PegIFN-α + SOF + RBV was lower than WPT.
Using “budget impact” analysis it was shown that switching to PegIFN-α
+ SOF + RBV from PegIFN-α + RBV regimen will involve extra direct costs
for antiviral treatment (AVT), but will lead to a reduction in medical aid costs
to the patients not reaching SVR, patients with CHC complications and, as a
consequence, will lead to a reduction in cumulative medical costs. Moreover,
transition from PegIFN-α + SMV + RBV, Dasabuvir + Ombitasvir/paritaprevir/
ritonavir and Dasabuvir + Ombitasvir/paritaprevir/ritonavir + RBV to PegIFN-α
+ SOF + RBV will lead to a reduction in both AVT costs and cumulative medical
costs.
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Bibliography link:
Kulikov A. Yu., Babiy V. V. Pharmacoeconomic analysis of sofosbuvir for the treatment of chronic hepatitis c (genotype 1) in the russian federation // Pharmacoeconomics: theory and practice. - 2017. - Vol.5, №4. - P.51-61 DOI: https://doi.org/10.30809/phe.4.2017.1
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