PharmacoEconomics & Outcomes News 784, p30 - 12 Aug 2017 Universal HCV treatment cost effective in Italy Universal treatment of hepatitis C virus (HCV) at any fibrosis stage appears to be cost effective in Italy, compared with treatment of prioritised patients and those with fibrosis stage F3 (policy 2), according to findings of a study published in Hepatology. A Markov model of liver disease progression populated with data from the PITER cohort (May 2014–December 2015) was used to evaluate the cost effectiveness of direct-acting antiviral (DAA) treatment in 8125 DAA-naıve patients with chronic HCV, under a universal policy versus policy 2 (prioritised/F3), from the perspective of the Italian National Health Service over a lifetime time horizon. The assumed treatment cost for DAA was €15 000 per patient. In the base-case analysis in Italy, universal treatment was estimated to gain 93 131 QALYs at a cost of €301 788 399, while policy 2 gained 89 490 QALYs at a cost of €269 841 561, resulting in an estimated incremental cost-effectiveness ratio (ICER) for universal DDA treatment versus policy 2 of €8775 per QALY gained. The ICER was below the willingness-to-pay (WTP) threshold of €20 000–€40 000 per QALY gained. In probabilistic sensitivity analysis, ICERs were below the lower WTP threshold in 94% of simulations and below the upper threshold in 97% of simulations. In a European scenario analysis, assuming a treatment cost of €30 000 and using data from France, Germany, Italy, Romania and the UK, the ICER for universal treatment was €19 542 per QALY gained. ICERs ranged from €9108 per QALY gained at a DDA cost of €15 000 to €26 498 per QALY gained at a DDA cost of €40 000. "Extending HCV treatment to patients at any fibrosis stage improves health outcomes and is cost effective. Cost-effectiveness significantly increases when lowering treatment prices in early fibrosis stages," concluded the authors. At DDA prices less than 75% of the €15 000 base price, universal treatment in patients with fibrosis stage F0–F2 became dominant (more effective and less costly) compared with prioritised treatment. Kondili LA, et al. Modelling cost-effectiveness and health gains of a "universal" vs. "prioritized" HCV treatment policy in a real-life cohort. Hepatology : 24 Jul 2017. Available from: URL: http://doi.org/10.1002/hep.29399 803262336 1173-5503/17/0784-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved PharmacoEconomics & Outcomes News 12 Aug 2017 No. 784
PharmacoEconomics & Outcomes News – Springer Journals
Published: Aug 12, 2017
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