Cost-effectiveness analysis of sofosbuvir-based regimens for chronic hepatitis C
Ramón San Miguel1, Vicente Gimeno-Ballester2, Antonio Blázquez3
1Department of Pharmacy, Complejo Hospitalario de Navarra, Pamplona, Spain.
Gut
|October 15, 2014
Summary
Sofosbuvir (SOF)-based regimens show cost-effectiveness for certain chronic hepatitis C (CHC) genotypes. SOF plus pIFN+RBV for 12 weeks is efficient for naive patients, while other regimens exceed cost thresholds.
Area of Science:
- Pharmacoeconomics
- Hepatology
- Public Health
Background:
- The introduction of sofosbuvir (SOF) is transforming chronic hepatitis C (CHC) treatment paradigms.
- Evaluating the economic viability of new SOF-based therapies is crucial for healthcare systems.
Purpose of the Study:
- To assess the cost-effectiveness of SOF-based treatment regimens compared to standard care for CHC.
- To analyze different genotypes and patient populations (naive and pretreated) within the Spanish healthcare system.
Main Methods:
- A lifetime Markov model simulated CHC progression to estimate costs and effects.
- Analysis included genotypes 1, 2, and 3 in naive patients and genotypes 2 and 3 in pretreated patients.
- One-way and probabilistic sensitivity analyses were conducted to assess parameter uncertainty.
Main Results:
- SOF plus pegylated-interferon-alfa (pIFN)+ribavirin (RBV) for 12 weeks was cost-effective for naive genotype 1 and 3 patients (€40,000/QALY threshold).
- SOF triple therapy for pretreated genotype 3 patients approached the cost-effectiveness threshold.
- Other SOF-based regimens exceeded the established efficiency limits.
Conclusions:
- A 12-week regimen of SOF+RBV+pIFN is cost-effective for specific CHC patient groups.
- Interferon-free regimens exceeding 12 weeks may surpass the cost-effectiveness benchmark.
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