Costs and outcomes of treating chronic hepatitis C patients in routine care – results from a nationwide multicenter trial

Stahmeyer, Jona T.; Krauth, Christian; Bert, F; Pfeiffer-Vornkahl, H.; Alshüth, U.; Hüppe, D; Mauss, Stefan; Rossol, S.

doi:10.1111/jvh.12471

Cited by 10 publications

(13 citation statements)

References 49 publications

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“…Regarding the results of our chart review, numerous studies in other countries have demonstrated similar findings, with antiviral drugs accounting for the majority of treatment costs 13,15,27–29. However, they estimate that antiviral costs would amount to around 75–85% of total costs, which is lower than our calculation of 92%.…”

Section: Discussionsupporting

confidence: 80%

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The cost of successful antiviral therapy in hepatitis C patients: a comparison of IFN-free versus IFN-based regimens at an individual patient level in Australia

Lee¹,

Driel²,

Crawford³

2017

CEOR

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BackgroundChronic hepatitis C remains a major global health burden with serious long-term consequences if left untreated. Recently the treatment standard of care has shifted to new interferon (IFN)-free drug regimens, which have been shown to be safe and effective. The aim of our study was to assess and compare medical resource utilization and costs of successfully treating patients with IFN-based and IFN-free therapies in Australia.MethodsWe performed a retrospective chart review of 30 HCV-infected patients successfully treated with IFN-based therapy between 2013 and 2015. We also generated a model for a virtual group of 100 genotype 1 (GT1) and 100 genotype 3 (GT3) patients treated with IFN-free therapy derived from national guidelines and clinical trial data.ResultsIn comparison to virtual patients receiving IFN-free therapy, our IFN-treated patients on average had distinctively more liver clinic visits and blood tests. However, mean total cost per patient was $19,164 and $85,300 (AUD) more for GT1 and GT3 patients receiving IFN-free therapy, respectively. This difference was largely accounted for by higher antiviral drug costs. Of our 30 patients treated with IFN, total mean cost per patient during the study period was $33,595.ConclusionResource utilization is lower with IFN-free treatment, which reflects the reduced need for patient monitoring and improved side-effect profile of these new drugs. However, total costs are still largely dominated by antiviral drug costs, representing a huge burden on national budgets. Our insight into resource utilization and costs associated with both types of treatment can serve as a reference for future studies.

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Section: Discussionsupporting

confidence: 80%

“…Several cohort studies performed in Germany and North America have looked at costs and MRU associated with dual and triple IFN-based therapy in routine clinical care 13–16…”

Section: Introductionmentioning

confidence: 99%

The cost of successful antiviral therapy in hepatitis C patients: a comparison of IFN-free versus IFN-based regimens at an individual patient level in Australia

Lee¹,

Driel²,

Crawford³

2017

CEOR

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“…These cost parameters include drugs, diagnostic procedures, and treatment, including treatment of side effects [18]. The costs applied for diagnostic procedures are based on Stahmeyer et al [23]. The costs per disease statuses were derived from published literature [24][25][26].…”

Section: Assumptions For Health State Costsmentioning

confidence: 99%

Cost-Effectiveness Analysis of Direct-Acting Antiviral Agents for Occupational Hepatitis C Infections in Germany

Runge

Westermann

Bindl

et al. 2020

IJERPH

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Around 1% of the world’s population is infected with hepatitis C. The introduction of new direct-acting antiviral agents (DAAs) in 2014 has substantially improved hepatitis C treatment outcomes. Our objective was to evaluate the long-term cost effectiveness of DAAs in health care personnel (HP) with confirmed occupational diseases in Germany. A standardised database from a German statutory accident insurance was used to analyse the cost-effectiveness ratio for the DAA regimen in comparison with interferon-based triple therapies. Taking account of the clinical progression of the disease, a Markov model was applied to perform a base case analysis for a period of 20 years. The robustness of the results was determined using a univariate deterministic sensitivity analysis. The results show that treatment with DAAs is more expensive, but also more effective than triple therapies. The model also revealed that the loss of 3.23 life years can be averted per patient over the 20 years. Compared to triple therapies, DAA treatment leads to a higher sustained virologic response (SVR). Although this results in a decrease of costs in the long term, e.g., pension payments, DAA therapy will cause greater expense in the future due to the high costs of the drugs.

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“…16-wöchige Therapie SVR-Raten von 88 % respektive 86 %[43]. Versorgung für die Dualtherapie mit PegIFN und RBV veröffentlicht[45].Bis zur Einführung der Kombinationstherapien mit Sofosbuvir wurde die Dualtherapie als Standardtherapie für die Genotypen 2 -6 empfohlen [6]. Die Analyse zeigt, dass die durchschnittlichen Kosten pro SVR für therapienaive Patienten bei 21 667 €/SVR für den Genotyp 2 und 22 218 €/SVR für den Genotyp 3 betragen.…”

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Kosten einer leitliniengerechten Versorgung von Hepatitis-C-Patienten im Zeitalter Interferon-freier Therapien

et al. 2016

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The treatment of chronic hepatitis C has considerably changed with the introduction of recent direct acting antivirals. These antivirals have sustained virologic response (SVR) rates above 90 % as well as reduced toxicity and treatment duration. Therefore, current German guidelines recommend these interferon-free regimens as first-choice treatment. Nevertheless, recent developments were accompanied by a significant increase in treatment costs, which led to extensive discussions on reasonable pharmaceutical prices. The aim of the current study was to analyze the average treatment costs and costs per patient cured for guideline treatment recommendations. Analyses were stratified according to genotype, treatment status (naive/experienced), and presence/absence of cirrhosis. Costs were separated in (1.) basic diagnostic procedures, (2.) monitoring, and (3.) pharmaceuticals. The calculation is based on a remuneration scheme in the statutory health insurance system. In treatment-naïve non-cirrhotic patients, the average cost is 41 766 €/SVR for the treatment with SOF/LDV calculated (PTV/r/OMV+DSV: 53 129 €/SVR). In treatment-naive cirrhotic patients, costs were 60 323 €/SVR (SOF/LDV+RBV) and 80 604 €/SVR (PTV/r/OMV+DSV+RBV). Treatment-experienced genotype 1 patients had average costs of 60 366 €/SVR for SOF/LDV treatment as well as 53 134 €/SVR for PTV/r/OMV+DSV±RBV treatment (cirrhotic patients: 62 208 €/SVR for SOF/LDV+RBV; 80 824 €/SVR for PTV/r/OMV+DSV+RBV). The average treatment costs per SVR in treatment-naive genotype 1 patients are comparable to previous standard of care treatments and lower in treatment-experienced patients. In other genotypes, treatment costs and costs per cure are significantly higher compared to previous standard of care. However, long-term modelling studies show that new regimens are cost-effective.

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Costs and outcomes of treating chronic hepatitis C patients in routine care – results from a nationwide multicenter trial

Cited by 10 publications

References 49 publications

The cost of successful antiviral therapy in hepatitis C patients: a comparison of IFN-free versus IFN-based regimens at an individual patient level in Australia

The cost of successful antiviral therapy in hepatitis C patients: a comparison of IFN-free versus IFN-based regimens at an individual patient level in Australia

Cost-Effectiveness Analysis of Direct-Acting Antiviral Agents for Occupational Hepatitis C Infections in Germany

Kosten einer leitliniengerechten Versorgung von Hepatitis-C-Patienten im Zeitalter Interferon-freier Therapien

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