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Cost-effectiveness analysis of sofosbuvir compared to current standard treatment in Swiss patients with chronic hepatitis C.

  • Pfeil AM Institute of Pharmaceutical Medicine (ECPM), University of Basel, Basel, Switzerland.
  • Reich O Department of Health Sciences, Helsana Group, Zurich, Switzerland.
  • Guerra IM OPTUMInsight, Uxbridge, Middlesex, United Kingdom.
  • Cure S OPTUMInsight, Uxbridge, Middlesex, United Kingdom.
  • Negro F Divisions of Gastroenterology and Hepatology and of Clinical Pathology, University Hospital Geneva, Geneva, Switzerland.
  • Müllhaupt B Swiss HPB (Hepato-Pancreato-Biliary) Center and Department of Gastroenterology and Hepatology, University Hospital Zürich, Zurich, Switzerland.
  • Lavanchy D World Health Organization (WHO), African Union, Governments, Denges VD, Switzerland.
  • Schwenkglenks M Institute of Pharmaceutical Medicine (ECPM), University of Basel, Basel, Switzerland.
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  • 2015-05-15
Published in:
  • PloS one. - 2015
Antiviral Agents
Cost-Benefit Analysis
Hepatitis C, Chronic
Humans
Markov Chains
Quality of Life
Quality-Adjusted Life Years
Sofosbuvir
Switzerland
English In clinical trials, sofosbuvir showed high antiviral activity in patients infected with hepatitis C virus (HCV) across all genotypes. We aimed to determine the cost-effectiveness of sofosbuvir-based treatment compared to current standard treatment in mono-infected patients with chronic hepatitis C (CHC) genotypes 1-4 in Switzerland. Cost-effectiveness was modelled from the perspective of the Swiss health care system using a lifetime Markov model. Incremental cost-effectiveness ratios (ICERs) used an endpoint of cost per quality-adjusted life year (QALY) gained. Treatment characteristics, quality of life, and transition probabilities were obtained from published literature. Country-specific model inputs such as patient characteristics, mortality and costs were obtained from Swiss sources. We performed extensive sensitivity analyses. Costs and effects were discounted at 3% (range: 0-5%) per year. Sofosbuvir-containing treatment in mixed cohorts of cirrhotic and non-cirrhotic patients with CHC genotypes 1-4 showed ICERs between CHF 10,337 and CHF 91,570 per QALY gained. In subgroup analyses, sofosbuvir dominated telaprevir- and boceprevir-containing treatment in treatment-naïve genotype 1 cirrhotic patients. ICERs of sofosbuvir were above CHF 100,000 per QALY in treatment-naïve, interferon eligible, non-cirrhotic patients infected with genotypes 2 or 3. In deterministic and probabilistic sensitivity analyses, results were generally robust. From a Swiss health care system perspective, treatment of mixed cohorts of cirrhotic and non-cirrhotic patients with CHC genotypes 1-4 with sofosbuvir-containing treatment versus standard treatment would be cost-effective if a threshold of CHF 100,000 per QALY was assumed.
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  • English
Open access status
gold
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Persistent URL
https://sonar.ch/global/documents/298422
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