engleski

Treatment of Chronic Hepatitis C Virus Genotype 1 Infection: Comparison of Health-Economic Outcomes for Naïve Patients

Objectives: During the past couple of years very effective direct acting antiviral (DAA) therapies for treating hepatitis C virus (HCV) infection appeared on the market. Beside high efficacy, these therapies are also designated by high prices in comparison to the therapy with pegylated interferon (pegIFN). The objective of presented work was to compare the cost-effectiveness of the therapies for HCV genotype 1 (GT1) naïve patients currently available on Croatian market. Methods: Costs of therapies were calculated according to publicly available medication pricing list and information found in Summary of Product Characteristics (SmPC) documents. The main health-economic outcome was defined as cost per cure i.e. therapy cost per achieved sustained viral response (SVR). Final parameters were estimated by Monte Carlo simulations. ANOVA and Tukey post-hoc test were used to test differences between mean therapies’ costs per SVR. Results: Currently on the Croatian market, there are five different treatments of HCV GT1 naïve patients. Those therapies are therapies with pegIFN that have SVR rates 30-55% as well as DAAs therapies with SVR range 60-100 % for naïve HCV GT1 patients. There is statistically significant difference (p < 0.001) among average treatment costs per SVR of the therapies and those are as low as €14, 800 for pegIFN and for new therapies reach €79, 600 in case of patients without cirrhosis. For cirrhotic patients prices are in range from €23, 400 for pegIFN, up to €91, 500 for DAA therapies. Conclusions: Due to the low costs per achieved SVR we can expect that in future there will still remain certain portion of naïve HCV GT1 patients who will receive pegIFN therapy. “Pay per cure” policy in which pharmaceutical company is not being paid for the drugs in cases in which patient does not achieve SVR, seems to be good solution for health providers and appropriate answer to high prices of the new therapies.

hepatitis C ; direct acting antiviral therapies ; health-economic outcomes

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