COST-EFFECTIVENESS OF ANTIVIRAL THERAPY IN TREATMENT-NAIVE PATIENTS WITH CHRONIC HEPATITIS C (GENOTYPE 1) WITH VARIOUS SEVERITY OF FIBROSIS STAGE

Interferon-free therapy for genotype 1 hepatitis C is highly effective at any severity of liver fibrosis. The purpose of work was to assess cost-effectiveness and the budget impact of paritaprevir/ombitasvir/dasabuvir/ ritonavir (PTV/OBV/DSV/r) ± ribavirin therapy depending on time treatment initiation at different stages of liver fibrosis. Materials and methods. The cost-effectiveness analysis was performed from the payer perspective using a Markov model with a lifetime and 10-year time horizon for male patients at the age of 45 years. The budget impact analysis was performed with the horizon of 10 years. In base case the analysis of PTV/OBV/DSV/r costs was carried out on the basis of estimated price of registration including VAT and the average wholesaler extra charge taking into account population of the Russian Federation. During cost-effectiveness assessment life expectancy and costs have been discounted for 3,5% a year. The budget impact analysis was performed without discounting. Results. In the analysis with a lifetime horizon the costeffectiveness of PTV/OBV/DSV/RTV + ribavirin for patients with genotype 1a is 66,71–392,02 thousand rubles/QALY. For HCV genotype 1b therapy with PTV/OBV/DSV/RTV can dominate over lack of antiviral therapy (i.e. to lead to cost saving at increase in life expectancy) (at F2) or to be up to 204,22 thousand rubles/QALY (at F0). The cost-effectiveness of PTV/OBV/DSV/RTV ± ribavirin at the 10-year horizon for HCV patients with genotype 1a varies within 575,68-1424,15 thousand rubles/QALY, and for HCV patients with genotype 1b – within 350,05–871,46 thousand rubles/QALY. The budget impact of PTV/OBV/DSV/RTV ± ribavirin decreases in some cases at earlier purpose of antiviral therapy. So, PTV/OBV/DSV/RTV + ribavirin therapy for patients with HCV with fibrosis 3 stage (genotype 1a), decreases budget impact by 27,5% in comparison with its prescription only after development of the compensated cirrhosis. Conclusions. PTV/OBV/DSV/RTV ± ribavirin therapy of HCV (genotype 1) may be considered as economically highly effective therapy for patients with any severity of liver fibrosis

chronic hepatitis C, genotype 1, naive patients, cost-effectiveness, budget impact analysis

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