Cost‐effectiveness of sofosbuvir plus ribavirin therapy for hepatitis C virus genotype 2 infection in South Korea

Abstract

Background and Aim For genotype 2 chronic hepatitis C (CHC), the efficacy and safety of sofosbuvir plus ribavirin therapy (SOF + RBV) was better than pegylated interferon plus ribavirin therapy (PR) at a greater drug cost. This study investigated the cost‐effectiveness of SOF + RBV compared with PR for treatment‐naïve genotype 2 CHC in South Korea. Methods Using a decision analytic Markov model, a cost‐effectiveness analysis comparing SOF + RBV with PR or no treatment for treatment‐naïve genotype 2 CHC was performed with probabilistic and deterministic sensitivity analyses from the payer's perspective in 2017. Three cohorts of patients aged 40–49, 50–59, and 60–69 years were simulated to progress through the fibrosis stages F0–F4 to end‐stage liver disease, hepatocellular carcinoma, or death. Published and calculated data on the clinical efficacy of the regimen, health‐related quality of life, costs, and transition probabilities were used. Results While the incremental cost‐effectiveness ratio for PR was dominant over no treatment, the incremental cost‐effectiveness ratios for SOF + RBV were $20 058 for the patients in their 40s, $19 662 for those in their 50s, and $22 278 for those in their 60s compared with PR. Probabilistic sensitivity analysis indicated an 89.0% probability for the SOF + RBV to be cost‐effective at a willingness to pay of $29 754.4 (per‐capita gross domestic product in 2017) for the patients in their 40s and 94.1% and 89.1% for the patients in their 50s and 60s, respectively. Conclusions The SOF + RBV is a cost‐effective option for genotype 2 treatment‐naïve CHC patients, especially for the patients with liver cirrhosis in Korea.