6533b829fe1ef96bd12898aa
RESEARCH PRODUCT
Personalized cost-effectiveness of boceprevir-based triple therapy for untreated patients with genotype 1 chronic hepatitis C
Salvatore PettaGiuseppe CabibboAntonio GasbarriniAntonio CraxìMarco EneaCalogero CammàMario EneaGiuseppe CabibboRaffaele BrunoAntonio GasbarriniSavino BrunoAntonella PlaiaFabio Salvatore Macalusosubject
MaleNational Health ProgramsCost effectivenessCost-Benefit AnalysisHepacivirusNational Health ProgramHepacivirusPharmacologyPolyethylene GlycolPolyethylene Glycolschemistry.chemical_compoundQuality-Adjusted Life YearMedicineSettore SECS-S/05 - Statistica SocialeMultivariate AnalysiBoceprevirSettore MED/12 - GastroenterologiabiologyMedicine (all)GastroenterologyMiddle AgedRecombinant ProteinMarkov ChainsRecombinant ProteinsModels EconomicTreatment OutcomeItalyDrug Therapy CombinationFemaleQuality-Adjusted Life YearsSettore SECS-S/01 - StatisticaViral loadHumanmedicine.medical_specialtyGenotypeProlineAlpha interferonInterferon alpha-2Antiviral AgentsInternal medicineBoceprevirRibavirinHumansCost-Benefit AnalysiAntiviral AgentHepaciviruPeg-interferonHepatologybusiness.industryRibavirinInterferon-alphaHepatologyHepatitis C ChronicMarkov Chainbiology.organism_classificationQuality-adjusted life yearchemistryCost-effectiveneMultivariate AnalysisQuality of LifeCost-effectivenessbusinessdescription
Abstract Background We assessed the cost-effectiveness of boceprevir-based triple therapy compared to peginterferon alpha and ribavirin dual therapy in untreated patients with genotype 1 chronic hepatitis C; patients were discriminated according to the combination of baseline plus on-treatment predictors of boceprevir-based triple therapy. Methods Cost-effectiveness analysis performed according to data from the available published literature. The target population was composed of untreated Caucasian patients, aged 50 years, with genotype 1 chronic hepatitis C, and these were evaluated over a lifetime horizon by Markov model. The study was carried out from the perspective of the Italian National Health Service. Outcomes included discounted costs (in euro, at 2013 value), life-years gained, quality-adjusted life year, and incremental cost-effectiveness ratio. The robustness of the results was evaluated by multivariable probabilistic sensitivity analyses. Results According to the baseline predictors of sustained virological response (genotype 1b, low viral load, fibrosis F0-F3, and body mass index) and the 1 Log drop of HCV-RNA after the dual therapy lead-in period, boceprevir was cost-effective in different patient profiles. Conclusions In untreated genotype 1b chronic hepatitis C patients, the cost-effectiveness of boceprevir-based triple therapy widely ranges according to different profiles of sustained virological response predictors, allowing optimization and personalization of triple therapy.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2014-01-01 |