TY - JOUR
T1 - Personalized cost-effectiveness of boceprevir-based triple therapy for untreated patients with genotype 1 chronic hepatitis C
AU - Plaia, Antonella
AU - Camma', Calogero
AU - Craxi, Antonio
AU - Enea, Marco
AU - Petta, Salvatore
AU - Cabibbo, Giuseppe
AU - Gasbarrini, Antonio
AU - Bruno, Raffaele
AU - Bruno, Savino
AU - Macaluso, Fabio Salvatore
PY - 2014
Y1 - 2014
N2 - Background: We assessed the cost-effectiveness of boceprevir-based triple therapy compared to peginterferon alpha and ribavirin dual therapy in untreated patients with genotype 1 chronic hepatitis C; patients were discriminated according to the combination of baseline plus on-treatment predictors of boceprevir-based triple therapy. Methods: Cost-effectiveness analysis performed according to data from the available published literature. The target population was composed of untreated Caucasian patients, aged 50 years, with genotype 1 chronic hepatitis C, and these were evaluated over a lifetime horizon by Markov model. The study was carried out from the perspective of the Italian National Health Service. Outcomes included discounted costs (in euro, at 2013 value), life-years gained, quality-adjusted life year, and incremental cost-effectiveness ratio. The robustness of the results was evaluated by multivariable probabilistic sensitivity analyses. Results: According to the baseline predictors of sustained virological response (genotype 1b, low viral load, fibrosis F0-F3, and body mass index) and the 1. Log drop of HCV-RNA after the dual therapy lead-in period, boceprevir was cost-effective in different patient profiles. Conclusions: In untreated genotype 1b chronic hepatitis C patients, the cost-effectiveness of boceprevir-based triple therapy widely ranges according to different profiles of sustained virological response predictors, allowing optimization and personalization of triple therapy.
AB - Background: We assessed the cost-effectiveness of boceprevir-based triple therapy compared to peginterferon alpha and ribavirin dual therapy in untreated patients with genotype 1 chronic hepatitis C; patients were discriminated according to the combination of baseline plus on-treatment predictors of boceprevir-based triple therapy. Methods: Cost-effectiveness analysis performed according to data from the available published literature. The target population was composed of untreated Caucasian patients, aged 50 years, with genotype 1 chronic hepatitis C, and these were evaluated over a lifetime horizon by Markov model. The study was carried out from the perspective of the Italian National Health Service. Outcomes included discounted costs (in euro, at 2013 value), life-years gained, quality-adjusted life year, and incremental cost-effectiveness ratio. The robustness of the results was evaluated by multivariable probabilistic sensitivity analyses. Results: According to the baseline predictors of sustained virological response (genotype 1b, low viral load, fibrosis F0-F3, and body mass index) and the 1. Log drop of HCV-RNA after the dual therapy lead-in period, boceprevir was cost-effective in different patient profiles. Conclusions: In untreated genotype 1b chronic hepatitis C patients, the cost-effectiveness of boceprevir-based triple therapy widely ranges according to different profiles of sustained virological response predictors, allowing optimization and personalization of triple therapy.
KW - Boceprevir; Cost-effectiveness; Peg-interferon; Antiviral Agents; Drug Therapy
KW - Chronic; Humans; Interferon-alpha; Italy; Male; Markov Chains; Middle Aged; Models
KW - Combination; Female; Genotype; Hepacivirus; Hepatitis C
KW - Economic; Multivariate Analysis; National Health Programs; Polyethylene Glycols; Proline; Quality of Life; Quality-Adjusted Life Years; Recombinant Proteins; Ribavirin; Treatment Outcome; Cost-Benefit Analysis; Gastroenterology; Hepatology; Medicine (all)
KW - Boceprevir; Cost-effectiveness; Peg-interferon; Antiviral Agents; Drug Therapy
KW - Chronic; Humans; Interferon-alpha; Italy; Male; Markov Chains; Middle Aged; Models
KW - Combination; Female; Genotype; Hepacivirus; Hepatitis C
KW - Economic; Multivariate Analysis; National Health Programs; Polyethylene Glycols; Proline; Quality of Life; Quality-Adjusted Life Years; Recombinant Proteins; Ribavirin; Treatment Outcome; Cost-Benefit Analysis; Gastroenterology; Hepatology; Medicine (all)
UR - http://hdl.handle.net/10447/155539
UR - http://www.elsevier.com/wps/find/journalbibliographicinfo.cws_home/623449/description#bibliographicinfo
M3 - Article
VL - 46
SP - 936
EP - 942
JO - Digestive and Liver Disease
JF - Digestive and Liver Disease
SN - 1590-8658
ER -