Estimating the clinical and economic benefit associated with incremental improvements in sustained virologic response in chronic hepatitis C
Related Experiment Video
Updated: Apr 18, 2026
A Protocol for Analyzing Hepatitis C Virus Replication
Published on: June 26, 2014
Phil McEwan1, Thomas Ward1, Hayley Bennett2
1HEOR Ltd, Singleton Court Business Park, Monmouth, Wales, United Kingdom; Swansea Centre for Health Economics, School of Human & Health Sciences, Swansea University, Wales, United Kingdom.
Insights
Increasing sustained virologic response (SVR) in hepatitis C virus (HCV) treatment significantly improves patient outcomes and reduces long-term costs. Higher SVR rates lead to greater life-years and quality-adjusted life-years, especially in advanced fibrosis stages.
Area of Science:
- Hepatology and Viral Gastroenterology
- Health Economics and Outcomes Research
- Markov Modeling in Clinical Research
Background:
- Hepatitis C virus (HCV) infection is a primary driver of chronic liver disease, posing significant risks for hepatic morbidity and mortality.
- Current HCV treatments achieve sustained virologic response (SVR) in 40-80% of patients, but the therapeutic landscape is rapidly advancing.
- Quantifying the clinical and economic benefits of improved SVR rates is crucial for evaluating new and emerging HCV therapies.
Purpose of the Study:
- To assess the clinical and economic advantages associated with achieving higher levels of sustained virologic response (SVR) in hepatitis C virus (HCV) patients.
- To model the long-term impact of varying SVR rates on life-years (LYs) and quality-adjusted life-years (QALYs).
- To estimate the associated healthcare costs for complication management across different fibrosis stages and SVR levels.
Main Methods:
- Utilized a pre-existing Markov model (MONARCH) to simulate the lifetime natural history of hepatitis C.
- Estimated discounted and non-discounted life-years (LYs) and quality-adjusted life-years (QALYs) for diverse SVR rates.
- Validated model projections against ten UK-specific HCV studies to ensure robustness and accuracy.
Main Results:
- Quality-adjusted life-year (QALY) estimates varied from 18.0 years (fibrosis stage F0) to 7.5 discounted years (fibrosis stage F4 untreated).
- Projected QALY gains per 10% SVR improvement ranged from 0.23 (F0) to 1.35 (F4) in 40-year-old patients (discounted and non-discounted).
- Discounted HCV-related costs were minimized at approximately £300 for successful treatment in F0/F1 stages, escalating to £49,300 for untreated F4 patients.
Conclusions:
- Projecting long-term clinical and economic consequences of chronic hepatitis C is essential for evaluating novel treatment strategies.
- Increased SVR rates demonstrably improve expected costs, life-years (LYs), and quality-adjusted life-years (QALYs) in hepatitis C patients.
- Model validation confirmed the robustness of the reported findings regarding the impact of SVR on patient outcomes and healthcare economics.
Introduction:
Hepatitis C virus (HCV) infection is one of the principle causes of chronic liver disease. Successful treatment significantly decreases the risk of hepatic morbidity and mortality. Current standard of care achieves sustained virologic response (SVR) rates of 40-80%; however, the HCV therapy landscape is rapidly evolving. The objective of this study was to quantify the clinical and economic benefit associated with increasing levels of SVR.
Methods:
A published Markov model (MONARCH) that simulates the natural history of hepatitis C over a lifetime horizon was used. Discounted and non-discounted life-years (LYs), quality-adjusted life-years (QALYs) and cost of complication management were estimated for various plausible SVR rates. To demonstrate the robustness of projections obtained, the model was validated to ten UK-specific HCV studies.
Results:
QALY estimates ranged from 18.0 years for those treated successfully in fibrosis stage F0 to 7.5 years (discounted) for patients in fibrosis stage F4 who remain untreated. Predicted QALY gains per 10% improvement in SVR ranged from 0.23 (F0) to 0.64 (F4) and 0.58 (F0) to 1.35 (F4) in 40 year old patients (discounted and non-discounted results respectively). In those aged 40, projected discounted HCV-related costs are minimised with successful treatment in F0/F1 (at approximately £ 300), increasing to £ 49,300 in F4 patients who remain untreated. Validation of the model to published UK cost-effectiveness studies produce R2 goodness of fit statistics of 0.988, 0.978 and of 0.973 for total costs, QALYs and incremental cost effectiveness ratios, respectively.
Conclusion:
Projecting the long-term clinical and economic consequences associated with chronic hepatitis C is a necessary requirement for the evaluation of new treatments. The principle analysis demonstrates the significant impact on expected costs, LYs and QALYs associated with increasing SVR. A validation analysis demonstrated the robustness of the results reported.
More Related Videos
11:34A Competent Hepatocyte Model Examining Hepatitis B Virus Entry through Sodium Taurocholate Cotransporting Polypeptide as a Therapeutic Target
Published on: May 10, 2022
12:24A Three-Dimensional Spheroid Model to Investigate the Tumor-Stromal Interaction in Hepatocellular Carcinoma
Published on: September 30, 2021
Related Concept Videos
01:28Viral Hepatitis I: Introduction
01:10Retrovirus Life Cycles
01:08Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment
01:30Inhibitors of Viral Protein Synthesis
01:22Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
01:25Hepatitis