A Cost-Utility Analysis of Different Antiviral Medicine Regimens in Patients With Chronic Hepatitis C Virus Genotype 1 Infection
نویسندگان
1 Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
2 Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, IR Iran
3 Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, IR Iran
4 Health Human Resource Research Center, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, IR Iran
5 Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, IR Iran
6 Health Human Resource Research Center, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, IR Iran
7 Institute of Health andWellbeing, Health Economics and Health Technology Assessment, University of Glasgow
doi
چکیده
Background: Despite the introduction of new drug regimens with high effectiveness for the hepatitis C virus (HCV) patients, especiallyin HCV genotype 1, no cost-effectiveness study on the selection of the superior drug strategy in Iran has been conductedyet.Objectives: This study is aimed to assess the cost-effectiveness of the three drug regimens of pegylated interferon and ribavirin (PR),sofosbuvir (SOF) + PR and ledipasvir and sofosbuvir (LDV/SOF) in patients with HCV genotype 1 in Iran in the year 2014.Methods: A Markov micro-simulation model was used to evaluate the cost-effectiveness of the three drug strategies for a cohortof 10000 patients. Quality-adjusted life-years (QALYs) were extracted from published studies. Cost data was estimated through thereview of medical records and obtaining experts opinion.Results: The results showed that the SOF + PR drug compared with PR had a lower cost and was more effective, but compared withthe LDV/SOF, in spite of its lower cost, it was less efficient. The QALY values obtained for PR, SOF + PR and LDV/SOF, respectively, were10.98, 12.08 and 12.28 and their costs were $ 41,741, $ 7,676 and $ 46,993. Moreover, the results obtained from acceptability curvesshowed that SOF + PR were the most cost-effective treatment for thresholds below $ 45,270 PPP.Conclusions: The use of SOF + PR regimen or LDV/SOF can significantly reduce the incidence of complications associated with thedisease. For example, short and long-term outcomes are better than the current drug regimens for HCV genotype 1 patients in allstages of the disease.
