Economic Consequences of Investing in Anti-HCV Antiviral Treatment from the Italian NHS Perspective: A Real-World-Based Analysis of PITER Data

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RESEARCH PRODUCT

Economic Consequences of Investing in Anti-HCV Antiviral Treatment from the Italian NHS Perspective: A Real-World-Based Analysis of PITER Data

Andrea Marcellusi Raffaella Viti Loreta A. Kondili Stefano Rosato Stefano Vella Francesco Saverio Mennini L. A. Kondili S. Vella M. G. Quaranta S. Rosato M. E. Tosti L. E. Weimer L. Ferrigno F. D’angelo L. Falzano A. Benedetti L. Schiadà M. Cucco A. Giacometti L. Brescini S. Castelletti D. Drenaggi C. Mazzaro G. Angarano M. Milella A. Di leo M. Rendina A. Contaldo A. Iannone F. La Fortezza M. Rizzi G. Cologni L. Bolondi F. Benevento I. Serio P. Andreone P. Caraceni V. Guarneri M. Margotti G. Simonetti G. Mazzella G. Verucchi V. Donati Peter Mian G. Rimenti A. Rossini G. B. Contessi Fulvio Castelli S. Zaltron A. Spinetti S. Odolini G. Leandro R. Cozzolongo M. Zappimbulso M. Russello R. Benigno C. Coco C. Torti C. Costa G. Greco M. Mazzitelli V. Pisani Lucia Cosco F. Quintieri Martina De Siena F. Giancotti J. Vecchiet K. Falasca A. Mastroianni G. Apuzzo L. Chidichimo F. G. Foschi A. C. Dall’aglio M. Libanore D. Segala L. Sighinolfi D. Bartolozzi E. Salomoni P. Blanc F. Baragli B. Del pin E. Mariabelli F. Mazzotta A. Poggi A. L. Zignego M. Monti Francesca Madia A. Xheka E. M. Cela T. A. Santantonio S. R. Bruno C. Viscoli A. I. Alessandrini C. Curti A. Di biagio L. A. Nicolini E. Balletto Chiara Mastroianni K. Blerta D. Prati L. Raffaele M. Andreoletti G. Perboni P. Costa L. Manzini G. Raimondo R. Filomia A. Lazzarin G. Morsica S. Salpietro M. Puoti C. Baiguera S. Vassalli M. G. Rumi S. Labanca M. Zuin A. Giorgini D. Orellana A. D’arminio monforte A. Debona S. Solaro S. Fargion L. Valenti G. Periti S. Pelusi M. Galli E. Calvi L. Milazzo A. Peri P. Lampertico Margherita Borghi R. D’ambrosio E. Degasperi Maria Rosaria Vinci E. Villa V. Bernabucci Luca Bristot F. Pereira L. Chessa M. C. Pasetto M. Loi A. Gori I. Beretta V. Pastore A. Soria M. Strazzabosco A. Ciaccio M. Gemma G. Borgia A. Foggia E. Zappulo I. Gentile A. R. Buonomo N. Abrescia A. Maddaloni N. Caporaso F. Morisco S. Camera L. Donnarumma C. Coppola D. C. Amoruso L. Staiano M. R. Saturnino N. Coppola S. Martini C. Monari Alex Federico M. Dallio C. Loguercio G. B. Gaeta G. Brancaccio G. Nardone C. Sgamato G. D’adamo A. Alberti M. Gonzo S. Piovesan L. Chemello A. Buggio L. Cavalletto F. Barbaro Enrico Castelli A. Floreani N. Cazzagon I. Franceschet F. P. Russo A. Zanetto E. Franceschet S. Madonia Maria Chiara Cannizzaro G. Montalto A. Licata A. R. Capitano A. Craxì S. Petta V. Calvaruso F. Rini C. Ferrari E. Negri A. Orlandini M. Pesci R. Bruno A. Lombardi V. Zuccaro R. Gulminetti A. Asti M. Villaraggia M. Mondelli S. Ludovisi F. Baldelli F. Di Candilo G. Parruti Paolo Di Stefano F. Sozio M. C. Gizzi M. R. Brunetto P. Colombatto B. Coco L. Surace G. Foti S. Pellicano G. Fornaciari S. Schianchi P. Vignoli M. Massari R. Corsini E. Garlassi G. Ballardini M. Andreoni C. Cerva M. Angelico Antonio Gasbarrini M. Siciliano Martina De Siena L. Nosotti G. Taliani E. Biliotti M. Santori M. Spaziante F. Tamburini V. Vullo G. D’ettorre E. N. Cavallari T. S. Gebremeskel P. Pavone Roberto Cauda Antonella Cingolani S. Lamonica G. D’offizi R. Lionetti U. Visco Comandini Antonio Grieco F. D’aversa A. Picardi A. De Vincentis G. Galati Patrizia Gallo C. Dell’unto A. Aghemo A. Gatti Comini M. Persico M. Masarone M. Anselmo P. De Leo Monia Marturano E. Brunelli F. Ridolfi A. M. Schimizzi M. Ayoubi Khajekini L. Framarin G. Di Perri G. Cariti L. Boglione C. Cardellino L. Marinaro G. M. Saracco A. Ciancio P. Toniutto G. Alterini F. Capra D. Ieluzzi

subject

Liver Cirrhosis Pediatrics Time Factors Settore MED/09 - Medicina Interna National Health Programs ERADICATION OUTBREAK antiviral treatment anti HCV economic consequences Hepacivirus LIVER FIBROSIS Severity of Illness Index Health Services Accessibility COST-EFFECTIVENESS Indirect costs 0302 clinical medicine Epidemiology virus infection 030212 general & internal medicine health care economics and organizations cost effectiveness 030503 health policy & services Health Policy Health services research health Hepatitis C Hepatitis C Markov Chains chronic hepatitis C virus infection fibrosis progression cost effectiveness liver fibrosis Italy Pharmacology; Health Policy; Public Health Environmental and Occupational Health Cohort Settore SECS-P/03 - Scienza delle Finanze Disease Progression Public Health 0305 other medical science Viral hepatitis Anti-HCV antiviral treatment CHRONIC HEPATITIS-C medicine.medical_specialty Genotype Settore MED/12 - GASTROENTEROLOGIA VIRUS-INFECTION Antiviral Agents NO 03 medical and health sciences Cost Savings Antiviral Agents; Cost Savings; Disease Progression; Genotype; Health Policy; Health Services Accessibility; Hepacivirus; Hepatitis C; Humans; Italy; Liver Cirrhosis; Markov Chains; National Health Programs; Severity of Illness Index; Time Factors medicine MANAGEMENT Humans chronic hepatitis C INDUCED DISEASES METAANALYSIS Pharmacology Health economics business.industry Public health Environmental and Occupational Health Public Health Environmental and Occupational Health medicine.disease FIBROSIS PROGRESSION business

description

OBJECTIVE:\ud We estimated the cost consequence of Italian National Health System (NHS) investment in direct-acting antiviral (DAA) therapy according to hepatitis C virus (HCV) treatment access policies in Italy.\ud \ud METHODS:\ud A multistate, 20-year time horizon Markov model of HCV liver disease progression was developed. Fibrosis stage, age and genotype distributions were derived from the Italian Platform for the Study of Viral Hepatitis Therapies (PITER) cohort. The treatment efficacy, disease progression probabilities and direct costs in each health state were obtained from the literature. The break-even point in time (BPT) was defined as the period of time required for the cumulative costs saved to recover the Italian NHS investment in DAA treatment. Three different PITER enrolment periods, which covered the full DAA access evolution in Italy, were considered.\ud \ud RESULTS:\ud The disease stages of 2657 patients who consecutively underwent DAA therapy from January 2015 to December 2017 at 30 PITER clinical centres were standardized for 1000 patients. The investment in DAAs was considered to equal €25 million, €15 million, and €9 million in 2015, 2016, and 2017, respectively. For patients treated in 2015, the BPT was not achieved, because of the disease severity of the treated patients and high DAA prices. For 2016 and 2017, the estimated BPTs were 6.6 and 6.2 years, respectively. The total cost savings after 20 years were €50.13 and €55.50 million for 1000 patients treated in 2016 and 2017, respectively.\ud \ud CONCLUSIONS:\ud This study may be a useful tool for public decision makers to understand how HCV clinical and epidemiological profiles influence the economic burden of HCV.

year	journal	country	edition	language
2019-02-28

10.1007/s40273-018-0733-3 http://hdl.handle.net/10807/129167