Cost-effectiveness Analysis of Glecaprevir/Pibrentasvir versus Elbasvir/Grazoprevir in Chronic Hepatitis C Genotype 1b Treatment-naive Patients without Cirrhosis / 中国药房

ABSTRACT

OBJECTIVE：To evalua te the economics of glecaprevir/pibrentasvir （G/P）versus elbasvir/grazoprevir （EBR/GZR） in chronic hepatitis C genotype 1b（GT1b）treatment-naive patients without cirrhosis ，and to provide evidence support for medical and health decision-making. METHODS ：Under assuming the bid price of G/P and EBR/GZR therapy schemes before medical insurance negotiation was adopted （scenario 1）and assuming that the price of EBR/GZR was reduced by 85％ and the price of G/P was reduced by 80％（scenario 2），Markov model was developed to simulate the lifetime cost and health outcomes progress of 10 000 untreated chronic hepatitis C GT 1b treatment-naive patients without cirrhosis and calculate incremental cost-effectiveness ratio（ICER）. Single factor sensitivity analysis and probability sensitivity analysis were conducted to verify the results. The highest price（price reduction ratio ）of G/P scheme was analyzed with cost-effectiveness advantage ，when other parametes kept stable under scenario 2. RESULTS ：Under 2 kinds of scenarios ，compared with EBR/GZR scheme ，G/P scheme had higher cost （scenario 1：68 800 yuan vs. 62 338 yuan；scenario 2：13 760 yuan vs. 11 490 yuan）and healty utility （scenario 1：14.97 QALY vs. 14.90 QALY；scenario 2：14.97 QALY vs. 14.90 QALY），and ICER value of G/P was lower than willingness-to-pay threshold （scenario 1：92 314 yuan/QALY；scenario 2：32 428 yuan/QALY）. The change of most parameters in single factor sensitivity analysis didn ’t influence the results of base-case analysis ，and the findings from the base-case analysis were confirmed by probability sensitivity analyses. The price of G/P scheme needed to be reduced by at least 62％ to realize cost-effective advantage. CONCLUSIONS ： Under the set price scenario ，G/P scheme has cost-effectiveness advantages than EBR/GZR scheme in chronic hepatitis C GT 1b treatment-naive patients without cirrhosis.