Cost-utility analysis of second-generation direct-acting antivirals for hepatitis C: a systematic review

Expert Review of Gastroenterology & Hepatology
Jaume Puig-JunoyMíriam Solozabal

Abstract

High prices of second-generation direct-acting antivirals (DAAs) in the treatment of chronic hepatitis C virus (HCV) patients led to reimbursement decisions based on cost per quality-adjusted life year (QALY). Areas covered: We performed a systematic review of cost-utility analyses (CUA) comparing interventions with second-generation DAA therapies with no treatment, and with previous therapies for chronic HCV patients until July 2017. A total of 36 studies were included: 30 studies from the perspective of the healthcare payer, 3 from the societal perspective, and 3 did not report the perspective. For genotype 1, the highest number of ICER comparison corresponds to sofosbuvir (SOF) triple therapy and SOF-based combinations which reported a cost per QALY systematically ranging from negative to lower than US$100,000 when compared with no treatment or dual therapy or Simeprevir triple therapy. Expert commentary: Selected studies may be overestimating the true cost per QALY of second-generation DAAs in the treatment of HCV, mainly because of neglecting non-healthcare costs, using official list prices which are higher than actual transaction prices and not adopting the long run drug price in a dynamic approach. In addition, the impac...Continue Reading

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Citations

Apr 30, 2020·The Pediatric Infectious Disease Journal·Hua ZhouDatian Che
Oct 29, 2019·Revista Española De Enfermedades Digestivas : Organo Oficial De La Sociedad Española De Patología Digestiva·Javier CrespoGloria Sánchez Antolín
Oct 9, 2019·Gastroenterología y hepatología·Javier CrespoGloria Sánchez Antolín
Jul 17, 2021·Liver International : Official Journal of the International Association for the Study of the Liver·Ignazio GrattaglianoClaudio Cricelli
Dec 3, 2021·The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care·Peter LindgrenBengt Jönsson

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