A real-world impact of cost-effectiveness of pegylated interferon/ribavarin regimens on treatment-naive chronic hepatitis C patients in Taiwan

作者：Tsai Pei Chien; Liu Ta Wei; Hsieh Meng Hsuan; Yeh Ming Lun; Liang Po Cheng; Lin Yi Hung; Huang Ching I; Huang Chung Feng; Hsieh Ming Yen; Hou Nai Jen; Lin Zu Yau; Chen Shinn Cherng; Huang Jee Fu; Dai Chia Yen; Chuang Wan Long; Yu Ming Lung

来源：The Kaohsiung Journal of Medical Sciences, 2017, 33(1): 44-49.

DOI：10.1016/j.kjms.2016.10.008

• Chronic hepatitis C
• Cost-effectiveness analysis
• Naive
• Pegylated interferon
• Ribavirin

Treatments with pegylated interferon/ribavirin (PEG-IFN/RBV) has been standard of-care in patients with chronic hepatitis C virus (HCV) (CHC) infection and reimbursed in Taiwan. However, the actual cost-effectiveness remains unclear. We aimed to evaluate a real-world cost-effectiveness for CHC patients treated with PEG-IFN/RBV by using a clinical cohort with linkage to the National Health Insurance Research Database of Taiwan. The total and itemized medical-care expenses of outpatient visits of 117 treatment-naive CHC patients with linkage to the two million sampling of the National Health Insurance Research Database were collected. Four components of costs were assessed, including antiviral agents, nonantiviral agents, laboratory testing and consultation costs. The cost per sustained virological response (SVR) achieved was calculated to evaluate the cost-effectiveness. The average cost per treatment in 117 naive Taiwanese CHC patients was $4620. With an overall SVR rate of 78.6%, the average cost per SVR was $5878. The average medical-care cost per treatment for 52 Genotype 1 (G1) patients was $5133, including $4420 for antivirals, $380 for nonantivirals, $302 for laboratory, and $78 for consultation, compared to $4209, $3635, $317, $233, and $56 for 65 Genotype 2 (G2) patients. With an SVR rate at 67.3% for G1 and 87.7% for G2 patients, the cost per SVR achieved was significantly higher in G1 patients than those in G2 patients ($7627 vs. $4799, p = 0.001). In the current study, we provided the real-world cost-effectiveness of PEG-IFN/RBV for treatment-naive CHC patients. The genotype-specific cost-effectiveness could enhance decision-making for policy-makers in the coming era of directly acting antiviral therapy.

• 出版日期2017-1