Economic evaluation of novel direct-acting antivirals in the treatment of chronic hepatitis c virus genotype 1b in china based on markov model / 中国药学杂志

ABSTRACT

OBJECTIVE: To evaluate the cost-effectiveness of combinations of different direct-acting antivirals(DAAs) for treatment-naive patients infected with chronic hepatitis C virus genotype 1b in China, which would provide pharmacoeconomic evidence for relevant health care decisions. METHODS: A Markov model was constructed based on the natural history of chronic hepatitis C to evaluate the quality-adjusted life years (QALYs) and direct medical costs for noncirrhotic patients and compensated cirrhotic patients from the payer perspective, and to further calculate incremental cost-effectiveness ratio (ICER) of different regimens. Lifetime horizon(100 years of age) and one year cycle length were adopted. A 5% discount rate was applied to both QALYs and costs. One-way sensitivity analysis and probabilistic sensitivity analysis were performed. RESULTS: Base-case analysis showed that six DAAs regimens not only gained QALYs but also reduced medical costs compared with no treatment and PR regimen. Among all the DAAs regimens, the combination of paritaprevir/ombitasvir/ritonavir+dasabuvir± ribavirin (POR+DAS±RBV) was the most cost-effective alternative for all the target population. The findings from the base-case analysis were confirmed by the sensitivity analyses. CONCLUSION: Among all the regimens, the combination of POR+DAS±RBV is the economically dominant regimen in the treatment of treatment-naive patients infected with chronic hepatitis C virus genotype 1b in China.