Background: About 400,000-500,000 people are infected with
hepatitis C in Germany. Long-term consequences are the development of
liver cirrhosis and
hepatocellular carcinoma. The introduction of first generation
protease inhibitors has significantly improved the treatment of
hepatitis C genotype 1 patients. The aim of the study was to assess the cost-effectiveness of triple
therapy with
telaprevir in Germany. Methods: We used a Markov model on
disease progression and natural history to assess the cost-effectiveness of triple
therapy with
telaprevir compared to standard treatment with pegylated
interferon and
ribavirin. Model structure and inputs were discussed with clinical experts. Deterministic and probabilistic sensitivity analyses were performed to verify the robustness of results. Results: The base-case analyses shows that triple
therapy results in higher costs (untreated patients: €48,446 vs. €30,691; previously treated patients: €63,228 vs. €48,603) and better outcomes (untreated patients: 16.85 qualily of life years [QALYs] vs. 15.97 QALYs; previously treated patients: 14.16 QALYs vs. 12.89 QALYs). The incremental cost-effectiveness ratio (ICER) was €20,131 per QALY and €30,567 per life year gained (LYG) for previously untreated patients. ICER in treatment experienced patients was €7,664 per QALY for relapse patients, €12,506 per QALY for partial responders and €28,429 per QALY for null responders. Results were robust in sensitivity analyses. Conclusion: Although triple
therapy with
telaprevir leads to additional costs, there is a high probability of being cost-effective for different thresholds. This health economic analysis makes an important contribution to current debates on cost savings and efficient resource allocation in the German healthcare sector.