The cost-effectiveness of daclatasvir-based regimens for the treatment of hepatitis C virus genotypes 1 and 4 in the UK. Issue 2 (February 2016)

• Record Type: Journal Article
• Authors: McEwan, Phil; Bennett, Hayley; Ward, Thomas; Webster, Samantha; Gordon, Jason; Kalsekar, Anupama; Yuan, Yong; Brenner, Michael
• Is Part Of: European journal of gastroenterology & hepatology. Volume 28:Issue 2(2016:Feb.)
• Publication Date: 2016-02
• Subjects: chronic hepatitis C -- cost-effectiveness -- cost–utility analysis -- daclatasvir -- direct-acting antivirals -- hepatitis C virus; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Digestive organs -- Diseases; Liver -- Diseases; Periodicals; 616.33
• DOI: 10.1097/MEG.0000000000000510
• Languages: English
• ISSNs: 0954-691X

Abstract

Abstract : Objective: This study aimed to determine the cost-effectiveness of daclatasvir in combination with other medicinal products for the treatment of patients with hepatitis C virus genotypes 1 and 4 and advanced liver disease in the UK. Methods: A published and validated Markov model designed to simulate the natural history of chronic hepatitis C was used to compare daclatasvir with relevant treatment options for patients with hepatitis C virus genotypes 1 and 4 and a METAVIR score of F3–F4. Patients were defined according to their treatment status; that is, naive, experienced or interferon ineligible/intolerant. Data inputs for the analysis were derived from published sources, UK-specific where possible. A lifetime horizon was used, with costs and benefits discounted at 3.5%. Results: Daclatasvir-based regimens are estimated to be cost-effective versus no treatment and established standard-of-care regimens, including telaprevir in combination with pegylated interferon-α+ribavirin (PR), boceprevir in combination with PR and PR alone (incremental cost-effectiveness ratio range: £3715–£15 408). The cost-effectiveness of daclatasvir-based regimens versus emerging regimens (sofosbuvir or simeprevir based) is less consistent, but was dominant or cost-effective (incremental cost-effectiveness ratio range: £1394–£28 393) in all except two scenarios. Conclusion: Daclatasvir-based regimens are expected to be highly cost-effective for the majority patients with advanced disease versus relevant comparator regimens, including newer direct-acting antiviral regimens.