A real world cost effectiveness analysis of interferon-based therapy for HCV naive super-responders

作者：Tsai Pei Chien; Liu Ta Wei; Huang Chung Feng; Yeh Ming Lun; Dai Chia Yen; Chuang Wan Long; Huang Jee Fu; Yu Ming Lung^*

来源：Journal of the Chinese Medical Association, 2018, 81(8): 670-675.

DOI：10.1016/j.jcma.2017.05.015

• Chronic hepatitis C
• Cost-effectiveness analysis
• Naive
• Pegylated interferon
• Response-guided therapy

Background: A direct-acting antiviral (DAA) era in hepatitis C virus (HCV) treatment is fast approaching; unfortunately, the availability and affordability of DAAs in Asia Pacific areas vary, making it difficult to develop universal HCV practice guidelines appropriate for the all Asian populations. This study aimed to evaluate the real-world cost-effectiveness of IFN-based therapy according to the current strategies with PegIFN/RBV for "easy-to-treat" to provide a reference for application of future DAA development for IFN-eligible, treatment nave HCV patients.
Methods: A total of 1032 chronic hepatitis C treatment-naive patients who corresponded to response-guided therapy (RGT) guidelines of PegIFN/RBV regimens were linked to the entire population of expenditures and order in the National Health Insurance Research Database of Taiwan. The average total cost per SVR achieved was calculated as the summation of the total cost for all treated patients/number of SVR cases.
Results: Current RGT suggested 24 weeks of PegIFN/RBV for GI naive patients with baseline LVL and RVR at treatment week 4 achieved an average treatment cost per SVR of $5090 +/- 2400. This was of superior cost-effectiveness compared with those other subgroups of GI patients. In terms of G2 patients, according to current RGT of 16 weeks of treatment duration, PegIFN/RBV treatment with RVR achieved was of a very competitive cost per SVR ($3237 +/- 488).
Conclusion: For a nave patient in the new DAA era, the PegIFN/RBV treatment might be conserved for those with all favorable risk parameters, considering the treatment duration and cost per SVR, in the resource-constrained countries.

• 出版日期2018-8