Cost-utility analysis of triple therapy with telaprevir in treatment-naïve hepatitis C patients
Introduction: The prevalence of Hepatitis C (HCV) in Spain is 2,5%, with a high morbimortality rate. Triple therapy based on telaprevir plus peginterferon/ribavirin ([T/PR]) has demonstrated to be an effective approach in treatment-naïve G1-HCV patients. This analysis evaluated, through a Markov mod...
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Elsevier
2014-09-01
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| Series: | Farmacia Hospitalaria |
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| Online Access: | http://www.aulamedica.es/fh/pdf/7640.pdf |
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| author | Blanca Gros María Buti Itziar Oyagüez Raúl J Andrade Miguel A. Serra Juan Turnes Miguel A. Casado |
| author_facet | Blanca Gros María Buti Itziar Oyagüez Raúl J Andrade Miguel A. Serra Juan Turnes Miguel A. Casado |
| author_sort | Blanca Gros |
| collection | DOAJ |
| description | Introduction: The prevalence of Hepatitis C (HCV) in Spain is 2,5%, with a high morbimortality rate. Triple therapy based on telaprevir plus peginterferon/ribavirin ([T/PR]) has demonstrated to be an effective approach in treatment-naïve G1-HCV patients. This analysis evaluated, through a Markov model, the incremental cost-effectiveness ratio of triple therapy compared to peginterferon/ ribavirin ([PR]) alone in naïve patients depending on fibrosis stage, from the Spanish Healthcare Authorities perspective.
Methods: Efficacy results and adverse events incidence were based on the combined results of ADVANCE and OPTIMIZE studies. Adverse events and disease-related costs (€, 2014) were built up from panel expert opinion except from transplant and post-transplant costs, taken from published data. Drug costs were obtained from national databases and adjusted for the mandatory deduction. Outcomes and costs were both discounted at 3%/year.
Results: The analysis shows higher costs and improved outcomes associated with [TR/PR] relative to [PR] alone, resulting in an incremental cost-effectiveness ratio (ICER) of €18,288/ QALY for all the cohort, €14,152QALY for moderate fibrosis, €11,364QALY for bridging fibrosis, €15,929/QALY for cirrhosis. Over a lifetime period, the use of [T/PR] could avoid 12 cirrhosis and 4 liver transplants per 1,000 patients compared to [PR] alone. The probabilistic analysis, following 10,000 Montecarlo simulations, demonstrated the probability of an ICER below a €30,000/QALY gained threshold of 69%. At a willingness- to-pay of €30,000/QALY, [T/PR] could be considered as an efficient option compared with [PR] alone for treatment-naïve genotype 1 HCV patients, over a lifetime horizon |
| format | Article |
| id | doaj-art-491c248eb1c24b72b727ea1e93491aeb |
| institution | Kabale University |
| issn | 1130-6343 2171-8695 |
| language | English |
| publishDate | 2014-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Farmacia Hospitalaria |
| spelling | doaj-art-491c248eb1c24b72b727ea1e93491aeb2025-01-02T16:24:38ZengElsevierFarmacia Hospitalaria1130-63432171-86952014-09-0138541842910.7399/fh.2014.38.5.7640Cost-utility analysis of triple therapy with telaprevir in treatment-naïve hepatitis C patientsBlanca Gros0María Buti1Itziar Oyagüez2Raúl J Andrade3Miguel A. Serra4Juan Turnes5Miguel A. Casado6Hospital Vall d’ Hebrón, BarcelonaPharmacoeconomics & Outcomes Research Iberia, Madrid.Pharmacoeconomics & Outcomes Research Iberia, MadridHospital Universitario Virgen de la Victoria, MálagaHospital Clínico de Valencia, Valencia. Universidad de Valencia, Valencia.Complejo Hospitalario Universitario de Pontevedra, Pontevedra. EspañaPharmacoeconomics & Outcomes Research Iberia, Madrid.Introduction: The prevalence of Hepatitis C (HCV) in Spain is 2,5%, with a high morbimortality rate. Triple therapy based on telaprevir plus peginterferon/ribavirin ([T/PR]) has demonstrated to be an effective approach in treatment-naïve G1-HCV patients. This analysis evaluated, through a Markov model, the incremental cost-effectiveness ratio of triple therapy compared to peginterferon/ ribavirin ([PR]) alone in naïve patients depending on fibrosis stage, from the Spanish Healthcare Authorities perspective. Methods: Efficacy results and adverse events incidence were based on the combined results of ADVANCE and OPTIMIZE studies. Adverse events and disease-related costs (€, 2014) were built up from panel expert opinion except from transplant and post-transplant costs, taken from published data. Drug costs were obtained from national databases and adjusted for the mandatory deduction. Outcomes and costs were both discounted at 3%/year. Results: The analysis shows higher costs and improved outcomes associated with [TR/PR] relative to [PR] alone, resulting in an incremental cost-effectiveness ratio (ICER) of €18,288/ QALY for all the cohort, €14,152QALY for moderate fibrosis, €11,364QALY for bridging fibrosis, €15,929/QALY for cirrhosis. Over a lifetime period, the use of [T/PR] could avoid 12 cirrhosis and 4 liver transplants per 1,000 patients compared to [PR] alone. The probabilistic analysis, following 10,000 Montecarlo simulations, demonstrated the probability of an ICER below a €30,000/QALY gained threshold of 69%. At a willingness- to-pay of €30,000/QALY, [T/PR] could be considered as an efficient option compared with [PR] alone for treatment-naïve genotype 1 HCV patients, over a lifetime horizonhttp://www.aulamedica.es/fh/pdf/7640.pdfHepatitis CTelaprevir; Genotype 1Cost-effectivenessPeginterferon alfa 2aRibavirine |
| spellingShingle | Blanca Gros María Buti Itziar Oyagüez Raúl J Andrade Miguel A. Serra Juan Turnes Miguel A. Casado Cost-utility analysis of triple therapy with telaprevir in treatment-naïve hepatitis C patients Farmacia Hospitalaria Hepatitis C Telaprevir ; Genotype 1 Cost-effectiveness Peginterferon alfa 2a Ribavirine |
| title | Cost-utility analysis of triple therapy with telaprevir in treatment-naïve hepatitis C patients |
| title_full | Cost-utility analysis of triple therapy with telaprevir in treatment-naïve hepatitis C patients |
| title_fullStr | Cost-utility analysis of triple therapy with telaprevir in treatment-naïve hepatitis C patients |
| title_full_unstemmed | Cost-utility analysis of triple therapy with telaprevir in treatment-naïve hepatitis C patients |
| title_short | Cost-utility analysis of triple therapy with telaprevir in treatment-naïve hepatitis C patients |
| title_sort | cost utility analysis of triple therapy with telaprevir in treatment naive hepatitis c patients |
| topic | Hepatitis C Telaprevir ; Genotype 1 Cost-effectiveness Peginterferon alfa 2a Ribavirine |
| url | http://www.aulamedica.es/fh/pdf/7640.pdf |
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