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Article: Cost–Utility of All-Oral Direct-Acting Antiviral Regimens for the Treatment of Genotype 1 Chronic Hepatitis C Virus-Infected Patients in Hong Kong

TitleCost–Utility of All-Oral Direct-Acting Antiviral Regimens for the Treatment of Genotype 1 Chronic Hepatitis C Virus-Infected Patients in Hong Kong
Authors
KeywordsHepatitis C
Chronic
Cost–utility analysis
Direct-acting antiviral agents
Elbasvir/grazoprevir
Issue Date2020
PublisherSpringer New York LLC. The Journal's web site is located at http://springerlink.metapress.com/openurl.asp?genre=journal&issn=0163-2116
Citation
Digestive Diseases and Sciences, 2020, Epub 2020-05-08 How to Cite?
AbstractBackground: Direct-acting antivirals (DAAs) are entering the hepatitis C virus (HCV) treatment landscape in Hong Kong, prompting the need for cost–effectiveness evaluations of these interventions to enable optimal use of healthcare resources. Aims: This study aimed to compare the cost–effectiveness of DAAs to standard-of-care pegylated interferon plus ribavirin (RBV) in treatment-naïve patients without significant liver fibrosis and to compare different DAAs in patients who are treatment-experienced and/or have advanced liver disease. Methods: A Markov model was constructed to evaluate cost–effectiveness over a lifetime time horizon from the payer perspective. The target population was treatment-naïve and treatment-experienced HCV genotype 1 patients, stratified by degree of liver fibrosis. The model consists of 16 health states encompassing METAVIR fibrosis score (F0–F4), treatment success or failure, decompensated cirrhosis, hepatocellular carcinoma, liver transplant, and liver-related death. The proportions of patients achieving sustained virologic response were obtained from clinical trials. Other inputs were obtained from published and local data. The primary outcome was incremental cost–utility ratio for each DAA versus pegylated interferon + ribavirin and among different DAAs. Results: In treatment-naïve F0–2 HCV patients, all DAAs were cost-effective in genotype 1a and daclatasvir + asunaprevir, elbasvir/grazoprevir, ledipasvir/sofosbuvir, and glecaprevir/pibrentasvir were cost-effective compared to pegylated interferon + ribavirin in genotype 1b. In genotypes 1a and 1b, treatment-experienced patients, and F3–4 patients, elbasvir/grazoprevir was the least costly DAA and economically dominant over most other DAAs. Conclusions: DAAs can be a cost-effective option for the treatment of genotype 1 HCV patients in Hong Kong, and elbasvir/grazoprevir is cost-effective.
Persistent Identifierhttp://hdl.handle.net/10722/282530
ISSN
2019 Impact Factor: 2.751
2015 SCImago Journal Rankings: 0.995

 

DC FieldValueLanguage
dc.contributor.authorYuen, M-F-
dc.contributor.authorLiu, S-H-
dc.contributor.authorSeto, WK-
dc.contributor.authorMak, L-Y-
dc.contributor.authorCorman, SL-
dc.contributor.authorHsu, DC-
dc.contributor.authorLee, MYK-
dc.contributor.authorKhan, TK-
dc.contributor.authorPuenpatom, A-
dc.date.accessioned2020-05-15T05:29:19Z-
dc.date.available2020-05-15T05:29:19Z-
dc.date.issued2020-
dc.identifier.citationDigestive Diseases and Sciences, 2020, Epub 2020-05-08-
dc.identifier.issn0163-2116-
dc.identifier.urihttp://hdl.handle.net/10722/282530-
dc.description.abstractBackground: Direct-acting antivirals (DAAs) are entering the hepatitis C virus (HCV) treatment landscape in Hong Kong, prompting the need for cost–effectiveness evaluations of these interventions to enable optimal use of healthcare resources. Aims: This study aimed to compare the cost–effectiveness of DAAs to standard-of-care pegylated interferon plus ribavirin (RBV) in treatment-naïve patients without significant liver fibrosis and to compare different DAAs in patients who are treatment-experienced and/or have advanced liver disease. Methods: A Markov model was constructed to evaluate cost–effectiveness over a lifetime time horizon from the payer perspective. The target population was treatment-naïve and treatment-experienced HCV genotype 1 patients, stratified by degree of liver fibrosis. The model consists of 16 health states encompassing METAVIR fibrosis score (F0–F4), treatment success or failure, decompensated cirrhosis, hepatocellular carcinoma, liver transplant, and liver-related death. The proportions of patients achieving sustained virologic response were obtained from clinical trials. Other inputs were obtained from published and local data. The primary outcome was incremental cost–utility ratio for each DAA versus pegylated interferon + ribavirin and among different DAAs. Results: In treatment-naïve F0–2 HCV patients, all DAAs were cost-effective in genotype 1a and daclatasvir + asunaprevir, elbasvir/grazoprevir, ledipasvir/sofosbuvir, and glecaprevir/pibrentasvir were cost-effective compared to pegylated interferon + ribavirin in genotype 1b. In genotypes 1a and 1b, treatment-experienced patients, and F3–4 patients, elbasvir/grazoprevir was the least costly DAA and economically dominant over most other DAAs. Conclusions: DAAs can be a cost-effective option for the treatment of genotype 1 HCV patients in Hong Kong, and elbasvir/grazoprevir is cost-effective.-
dc.languageeng-
dc.publisherSpringer New York LLC. The Journal's web site is located at http://springerlink.metapress.com/openurl.asp?genre=journal&issn=0163-2116-
dc.relation.ispartofDigestive Diseases and Sciences-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectHepatitis C-
dc.subjectChronic-
dc.subjectCost–utility analysis-
dc.subjectDirect-acting antiviral agents-
dc.subjectElbasvir/grazoprevir-
dc.titleCost–Utility of All-Oral Direct-Acting Antiviral Regimens for the Treatment of Genotype 1 Chronic Hepatitis C Virus-Infected Patients in Hong Kong-
dc.typeArticle-
dc.identifier.emailYuen, M-F: mfyuen@hku.hk-
dc.identifier.emailLiu, S-H: drkliu@hku.hk-
dc.identifier.emailSeto, WK: wkseto@hku.hk-
dc.identifier.emailMak, L-Y: lungyi@HKUCC-COM.hku.hk-
dc.identifier.authorityYuen, M-F=rp00479-
dc.identifier.authoritySeto, WK=rp01659-
dc.identifier.authorityMak, L-Y=rp02668-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1007/s10620-020-06281-8-
dc.identifier.hkuros309970-
dc.identifier.volumeEpub 2020-05-08-
dc.publisher.placeUnited States-

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