Cost-Effectiveness of Boceprevir or Telaprevir for Untreated Patients withGenotype 1 Chronic Hepatitis C

Vito Di Marco, Calogero Camma', Vincenza Capursi, Fabrizio Bronte, Marco Enea, Salvatore Petta, Antonio Craxi, Antonio Gasbarrini, Americo Cicchetti, Calogero Cammà, Raffaele Bruno, Giorgio L. Colombo

Risultato della ricerca: Articlepeer review

98 Citazioni (Scopus)

Abstract

BACKGROUND AND AIMS:Randomized controlled trials (RCTs) show that triple therapy (TT) with peginterferon alfa, ribavirin and boceprevir (BOC) or telaprevir (TVR) is more effective than peginterferon-ribavirin dual therapy (DT) in the treatment of previously untreated patients with genotype 1 (G1) chronic hepatitis C (CHC). We assess the cost-effectiveness of TT compared to DT in the treatment of untreated patients with G1 CHC.METHODS:We created a Markov Decision Model to evaluate, in an untreated Caucasian patients aged 50 years, weight 70 kg, with G1 CHC and Metavir F2 liver fibrosis score, for a time horizon of twenty years, the cost-effectiveness of the following 5 competing strategies: 1) Boceprevir response-guided therapyy (BOC-RGT); 2) Boceprevir IL28B genotype-guided strategy (BOC-IL28B); 3) Boceprevir rapid virologic response (RVR) guided strategy (BOC-RVR); 4) Telaprevir response-guided theapyy (TVR-RGT); 5) Telaprevir IL28B genotype-guided strategy (TVR-IL28B). Outcomes included life-years gained (LYG), costs (in 2011 euros), and incremental cost-effectiveness ratio (ICER).RESULTS:In the base case analysis BOC-RVR and TVR-IL28B strategies were the most effective and cost-effective of evaluated strategies. LYG was 4.04 with BOC-RVR, and 4.42 with TVR-IL28B. ICER compared with DT was €8.304 per LYG for BOC-RVR, and €11.455 per LYG for TVR-IL28B. The model was highly sensitive to IL28B CC genotype, likelihood of RVR and of sustained virologic response, and BOC/TVR prices.CONCLUSIONS:In untreated G1 CHC patients aged 50 years, TT with first generation protease inhibitors is cost-effective compared with DT. Multiple strategies to reduce costs and improve effectiveness include RVR or genotype-guided treatment. (HEPATOLOGY 2012.).
Lingua originaleEnglish
Numero di pagine0
RivistaHEPATOLOGY
Volumeaccepted article ahead of print
Stato di pubblicazionePublished - 2012

All Science Journal Classification (ASJC) codes

  • Hepatology

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