New oral therapies for adolescents with HCV more cost-effective than PR strategy
Novel oral regimens for adolescents with hepatitis C virus (HCV) appears to be cost-effective compared with pegylated interferon α with ribavirin (PR) therapies, but only in the context of China and the US, suggests a recent study.
This analysis sought to assess the cost-effectiveness of oral regimens relative to that of PR strategies in adolescents in the US and China.
The investigators developed a Markov model to measure the economic and health outcomes of ledipasvir/sofosbuvir (LS) for genotypes 1 and 4, sofosbuvir/ribavirin (SR) for genotype 2, and ledipasvir/sofosbuvir/ribavirin (LSR) for genotype 3 HCV infection compared with the outcomes of PR treatment. They obtained clinical costs and utility inputs from published sources.
The following outcomes were measured: lifetime discounted quality-adjusted life years (QALYs), costs, and incremental cost-effectiveness ratios (ICERs). One-way and probabilistic sensitivity analyses facilitated the uncertainty.
In the US, the ICERs of LS treatment were $14,699/QALY for genotype 1 HCV infection and $14,946/QALY for genotype 4 in comparison to the PR strategy. Additionally, the ICER of SR strategy was $42,472/QALY for genotype 2, while that of LSR was $49,409/QALY for genotype 3.
In the Chinese context, LS for genotypes 1 and 4, SR for genotype 2, and LSR for genotype 3 were the major alternative treatments to the PR strategy. Of note, these results were robust to sensitivity analyses.
“Novel oral regimes have been approved for treating HCV infection in adolescents due to their superior effectiveness and safety,” the investigators noted.