Personalized cost-effectiveness of boceprevir-based triple therapy for untreated patients with genotype 1 chronic hepatitis C.

Abstract

BACKGROUND:

We assessed the cost-effectiveness of boceprevir-based triple therapy compared to peginterferon alpha and ribavirin dual therapy in untreated patients with genotype 1 chronic hepatitis C; patients were discriminated according to the combination of baseline plus on-treatment predictors of boceprevir-based triple therapy.

METHODS:

Cost-effectiveness analysis performed according to data from the available published literature. The target population was composed of untreated Caucasian patients, aged 50 years, with genotype 1 chronic hepatitis C, and these were evaluated over a lifetime horizon by Markov model. The study was carried out from the perspective of the Italian National Health Service. Outcomes included discounted costs (in euro, at 2013 value), life-years gained, quality-adjusted life year, and incremental cost-effectiveness ratio. The robustness of the results was evaluated by multivariable probabilistic sensitivity analyses.

RESULTS:

According to the baseline predictors of sustained virological response (genotype 1b, low viral load, fibrosis F0-F3, and body mass index) and the 1Log drop of HCV-RNA after the dual therapy lead-in period, boceprevir was cost-effective in different patient profiles.

CONCLUSIONS:

In untreated genotype 1b chronic hepatitis C patients, the cost-effectiveness of boceprevir-based triple therapy widely ranges according to different profiles of sustained virological response predictors, allowing optimization and personalization of triple therapy.

• Authors: Salvatore Petta, Giuseppe Cabibbo, Marco Enea, Fabio Salvatore Macaluso, Antonella Plaia, Raffaele Bruno, Antonio Gasbarrini, Savino Bruno, Antonio Craxì, Calogero Cammà, WEF study group
• Journal: Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver (Dig Liver Dis) Vol. 46 Issue 10 Pg. 936-42 (Oct 2014) ISSN: 1878-3562 [Electronic] Netherlands
• PMID: 25066806 (Publication Type: Comparative Study, Evaluation Study, Journal Article)
• Copyright: Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Chemical References

• Antiviral Agents
• Interferon alpha-2
• Interferon-alpha
• Recombinant Proteins
• Polyethylene Glycols
• Ribavirin
• N-(3-amino-1-(cyclobutylmethyl)-2,3-dioxopropyl)-3-(2-((((1,1-dimethylethyl)amino)carbonyl)amino)-3,3-dimethyl-1-oxobutyl)-6,6-dimethyl-3-azabicyclo(3.1.0)hexan-2-carboxamide
• Proline
• peginterferon alfa-2b
• peginterferon alfa-2a

Topics

• Antiviral Agents (economics, therapeutic use)
• Cost-Benefit Analysis
• Drug Therapy, Combination
• Female
• Genotype
• Hepacivirus (genetics)
• Hepatitis C, Chronic (drug therapy, economics, virology)
• Humans
• Interferon alpha-2
• Interferon-alpha (economics, therapeutic use)
• Italy
• Male
• Markov Chains
• Middle Aged
• Models, Economic
• Multivariate Analysis
• National Health Programs (economics)
• Polyethylene Glycols (economics, therapeutic use)
• Proline (analogs & derivatives, economics, therapeutic use)
• Quality of Life
• Quality-Adjusted Life Years
• Recombinant Proteins (economics, therapeutic use)
• Ribavirin (economics, therapeutic use)
• Treatment Outcome