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Cost-Effectiveness of Boceprevir in Patients Previously Treated for Chronic Hepatitis C Genotype 1 Infection in the United States

Chhatwal, Jagpreet, PhD ; Ferrante, Shannon A., PhD ; Brass, Cliff, MD, PhD ; El Khoury, Antoine C., PhD ; Burroughs, Margaret, MD ; Bacon, Bruce, MD ; Esteban-Mur, Rafael, MD ; Elbasha, Elamin H., PhD

Value in health, 2013-09, Vol.16 (6), p.973-986 [Periódico revisado por pares]

New York, NY: Elsevier Inc

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Título:
Cost-Effectiveness of Boceprevir in Patients Previously Treated for Chronic Hepatitis C Genotype 1 Infection in the United States
Autor: Chhatwal, Jagpreet, PhD ; Ferrante, Shannon A., PhD ; Brass, Cliff, MD, PhD ; El Khoury, Antoine C., PhD ; Burroughs, Margaret, MD ; Bacon, Bruce, MD ; Esteban-Mur, Rafael, MD ; Elbasha, Elamin H., PhD
Assuntos: Adult ; Aged ; Antiviral Agents - therapeutic use ; Biological and medical sciences ; Cohort Studies ; Cost effectiveness ; Cost of Illness ; Cost-Benefit Analysis ; Female ; General aspects ; Genotype ; Hepacivirus - drug effects ; Hepacivirus - genetics ; Hepatitis C ; Hepatitis C virus ; Hepatitis C, Chronic - drug therapy ; Humans ; Infection ; Internal Medicine ; Male ; Markov model ; Medical sciences ; Middle Aged ; Miscellaneous ; Outcome Assessment, Health Care ; Planification. Prevention (methods). Intervention. Evaluation ; Proline - analogs & derivatives ; Proline - economics ; Proline - therapeutic use ; protease inhibitor ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Quality of life ; Quality-Adjusted Life Years ; Randomized Controlled Trials as Topic ; Thresholds ; United States ; Willingness to pay
É parte de: Value in health, 2013-09, Vol.16 (6), p.973-986
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Descrição: Abstract Objectives The phase 3 trial, Serine Protease Inhibitor Boceprevir and PegIntron/Rebetol-2 (RESPOND-2), demonstrated that the addition of boceprevir (BOC) to peginterferon-ribavirin (PR) resulted in significantly higher rates of sustained virologic response (SVR) in previously treated patients with chronic hepatitis C virus (HCV) genotype-1 infection as compared with PR alone. We evaluated the cost-effectiveness of treatment with BOC in previously treated patients with chronic hepatitis C in the United States using treatment-related data from RESPOND-2 and PROVIDE studies. Methods We developed a Markov cohort model to project the burden of HCV disease, lifetime costs, and quality-adjusted life-years associated with PR and two BOC-based therapies—response-guided therapy (BOC/RGT) and fixed-duration therapy for 48 weeks (BOC/PR48). We estimated treatment-related inputs (efficacy, adverse events, and discontinuations) from clinical trials and obtained disease progression rates, costs, and quality-of-life data from published studies. We estimated the incremental cost-effectiveness ratio (ICER) for BOC-based regimens as studied in RESPOND-2, as well as by patient’s prior response to treatment and the IL-28B genotype. Results BOC-based regimens were projected to reduce the lifetime incidence of liver-related complications by 43% to 53% in comparison with treatment with PR. The ICER of BOC/RGT in comparison with that of PR was $30,200, and the ICER of BOC/PR48 in comparison with that of BOC/RGT was $91,500. At a willingness-to-pay threshold of $50,000, the probabilities of BOC/RGT and BOC/PR48 being the preferred option were 0.74 and 0.25, respectively. Conclusions In patients previously treated for chronic HCV genotype-1 infection, BOC was projected to increase quality-adjusted life-years and reduce the lifetime incidence of liver complications. In addition, BOC-based therapies were projected to be cost-effective in comparison with PR alone at commonly used willingness-to-pay thresholds.
Editor: New York, NY: Elsevier Inc
Idioma: Inglês

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Cost-Effectiveness of Boceprevir in Patients Previously Treated for Chronic Hepatitis C Genotype 1 Infection in the United States

Chhatwal, Jagpreet, PhD ; Ferrante, Shannon A., PhD ; Brass, Cliff, MD, PhD ; El Khoury, Antoine C., PhD ; Burroughs, Margaret, MD ; Bacon, Bruce, MD ; Esteban-Mur, Rafael, MD ; Elbasha, Elamin H., PhD

New York, NY: Elsevier Inc

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