Economic evaluation of Zepatier for the management of HCV in the Italian scenario

F. R. Rolli (), M. Ruggeri (), F. Kheiraoui (), Carlo Drago, M. Basile (), C. Favaretti () and A. Cicchetti ()
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F. R. Rolli: Catholic University of Sacred Heart
M. Ruggeri: Catholic University of Sacred Heart
F. Kheiraoui: Catholic University of Sacred Heart
M. Basile: Catholic University of Sacred Heart
C. Favaretti: VIHTALI, Value in Health Technology and Academy for Leadership and Innovation Spin-Off of the Catholic University of Sacred Heart
A. Cicchetti: Catholic University of Sacred Heart

The European Journal of Health Economics, 2018, vol. 19, issue 9, No 12, 1365-1374

Abstract: Abstract Background Hepatitis C virus (HCV) is a major health issue worldwide. New generation of direct-active antiviral medications is an epoch-making turning point in the management of HCV infections. Objective Conducing a cost-effectiveness analysis comparing the combination of elbasvir/grazoprevir and sofosbuvir + pegylated interferon/ribavirin for the management of all HCV patients (even those in the initial stages of fibrosis). Methods A Markov model was built on the natural history of the disease to assess the efficacy of the alternatives. The outcomes are expressed in terms of quality adjusted life-years (QALYs) and result in terms of incremental cost-effectiveness ratio). Results Elbasvir/grazoprevir implies an expenditure of €21,104,253.74 with a gain of 19,287.90 QALYs and sofosbuvir + pegylated interferon/ribavirin implies an expenditure of €31,904,410.11 with a gain of 18,855.96 QALYs. Elbasvir/grazoprevir is thus a dominant strategy. Conclusion Consideration should be given to the opportunity cost of not treating patients with a lower degree of fibrosis (F0–F2).

Keywords: Cost-effectiveness analysis; ICER; Sensitivity analysis; Opportunity cost; HCV (search for similar items in EconPapers)
JEL-codes: H51 (search for similar items in EconPapers)
Date: 2018
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DOI: 10.1007/s10198-018-0980-4

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