Value in Hepatitis C Virus Treatment: A Patient-Centered Cost-Effectiveness Analysis

Area of Science:

• Health Economics
• Pharmacoeconomics
• Public Health

Background:

• Traditional hepatitis C virus (HCV) evaluations focus on virologic cure, neglecting patient-reported challenges.
• A patient-centered approach is needed to assess the full value of HCV therapies.

Purpose of the Study:

• To evaluate the cost-effectiveness of HCV drug therapy using a patient-centered methodology.
• To compare direct-acting antivirals (DAAs) against no treatment from both health sector and societal perspectives.

Main Methods:

• An individual-based Markov model was developed with stakeholder and patient input.
• Evaluated 10- and 20-year time horizons considering US health sector and societal costs.
• Incorporated novel outcomes: infected life-years and workdays missed, alongside quality-adjusted life-years (QALYs).

Main Results:

• DAA treatment increased health sector costs and QALYs but reduced infected life-years and workdays missed.
• The DAA intervention was cost-saving over 10 and 20 years when including indirect costs like absenteeism and patient time.
• Societal model results were sensitive to presenteeism and drug costs; health sector results were sensitive to drug costs and post-SVR utility.

Conclusions:

• HCV treatment with DAAs is cost-effective from a health sector viewpoint.
• Including non-health costs demonstrates that DAA therapy is cost-saving, highlighting the value of a patient-centered approach.