Your browser doesn't support javascript.
loading
Cost-effectiveness analysis of glecaprevir/pibrentasvir regimen for treating Chinese patients with chronic hepatitis C genotype 1 and genotype 2 infection.
Zhou, Hui-Jun; Wu, Gang; Li, Ji-Ming; Naidoo, Nasheen; Xie, Yan-Xiang; Feng, Bo-Lan; Wang, Pei; Luo, Ji-Wei.
Afiliação
  • Zhou HJ; Department of Public Administration, Business School, University of Shanghai for Science & Technology, Shanghai, China.
  • Wu G; Department of Medical Records, 900th Hospital of Joint Logistics Support Force, Fuzhou, China.
  • Li JM; Department of Experimental Center, Business School, University of Shanghai for Science & Technology, Shanghai, China; .
  • Naidoo N; Department of Pathology, Stellenbosch University, Cape Town, South Africa.
  • Xie YX; Department of Infectious Disease, The 79th group army hospital of PLA, Liaoyang, China.
  • Feng BL; Department of Public Administration, Business School, University of Shanghai for Science & Technology, Shanghai, China.
  • Wang P; Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), Shanghai, China; School of Public Health, Fudan University, Shanghai, China.
  • Luo JW; Department of Orthopedics, Zengcheng Branch, Nanfang Hospital, Nanfang Medical University, Guangzhou, China.
Ann Palliat Med ; 10(10): 10313-10326, 2021 10.
Article em En | MEDLINE | ID: mdl-34670381
BACKGROUND: Hepatitis C virus (HCV) infection is an important health threat in China to which direct acting antivirals (DAAs) are very effective. In 2019, another novel DAA glecaprevir/pibrentasvir (GLE/PIB) was officially approved. Knowledge of its cost-effectiveness would be informative for clinical decision-making but has not been evaluated. This study aims to evaluate the cost-effectiveness of GLE/PIB to inform policy-making on drug reimbursement and HCV eradication. METHODS: Markov models were developed from the payers' perspective and simulated the lifetime experience of adult patients chronically infected with HCV genotype 1 or genotype 2. Two regimens, GLE/PIB and pegylated interferon (pegIFN) plus ribavirin (RBV), were compared in cost and quality adjusted life years (QALY) with both outcomes being discounted to 2020 values. The incremental cost-effectiveness ratio (ICER) was computed to reflect the incremental benefit of GLE/PIB versus pegIFN + RBV. The robustness of the model outcomes was examined using deterministic and probabilistic sensitivity analysis (PSA) to identify influential parameters and to assess the probability of GLE/PIB being cost-effective. The GDP per capita in China in 2019 ($10,275) was used as the threshold for cost-effectiveness. RESULTS: For the entire target population, GLE/PIB was the dominant regimen attaining a cost-saving of $255 and 1.17 more QALYs relative to pegIFN + RBV. The finding was more pronounced for HCV genotype 1 infection by saving $1,656 and creating 1.37 more QALYs. At the $10,275 threshold, the probability of GLE/PIB being cost-effective was 99.32% overall and 99.85% for HCV genotype 1 infection. The age of starting DAA treatment, price of pegIFN + RBV, cost of cirrhosis treatment and duration of the GLE/PIB regimen were the five most influential factors. For the patients with HCV genotype 2 infection, the ICER of GLE/PIB was $12,914/QALY with 95% confidence interval of $4,047/QALY to $37,640/QALY. The GLE/PIB regimen statistically cannot be ruled out as a cost-effective option for HCV genotype 2 infection. CONCLUSIONS: GLE/PIB is a cost-effective strategy to treat chronic HCV genotype 1 and HCV genotype 2 infection in China. This regimen should be initiated at a younger age to maximize its value. To achieve national eradication, it may be timely to consider replacing pegIFN + RBV with DAAs, such as GLE/PIB, as the first-line treatment.
Assuntos
Palavras-chave

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Antivirais / Hepatite C Crônica Tipo de estudo: Health_economic_evaluation / Prognostic_studies Limite: Adult / Humans País como assunto: Asia Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Antivirais / Hepatite C Crônica Tipo de estudo: Health_economic_evaluation / Prognostic_studies Limite: Adult / Humans País como assunto: Asia Idioma: En Ano de publicação: 2021 Tipo de documento: Article