Cost-effectiveness of Interferon-free therapy for Hepatitis C in Germany - an application of the efficiency frontier approach

BMC Infectious Diseases

Research Article

Georg Götz¹  Christian Gissel²  Holger Repp³  Jörg Mahlich⁴ 

[1] Department of Economics and Business, Justus Liebig University Giessen, Giessen, Germany;Department of Economics and Business, Justus Liebig University Giessen, Giessen, Germany;General Medicine, Department of Medicine, Justus Liebig University Giessen, Klinikstrasse 32, 35392, Giessen, Germany;General Medicine, Department of Medicine, Justus Liebig University Giessen, Klinikstrasse 32, 35392, Giessen, Germany;Janssen Pharmaceutical K.K., 5-2, Nishi-kanda 3-chome, 101-0065, Chiyoda-ku, Tokyo, Japan;Düsseldorf Institute for Competition Economics (DICE), University of Düsseldorf, Düsseldorf, Germany;

关键词: Hepatitis C;    Interferon-free therapy;    Sofosbuvir;    Simeprevir;    Cost-effectiveness;    Germany;    Efficiency frontier;   

DOI  :  10.1186/s12879-015-1048-z

 received in 2014-11-26, accepted in 2015-07-21,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundThe approval of direct-acting antivirals for Interferon-free treatment revolutionized the therapy of chronic Hepatitis C infection. As of August 2014, two treatment regimens for genotype 1 infection received conditional approval in the European Union: Sofosbuvir and Ribavirin for 24 weeks and Sofosbuvir and Simeprevir with or without Ribavirin for 12 weeks. We aim to analyze the cost-effectiveness of both regimens in Germany.MethodsWe set up a Markov model with a lifetime horizon to simulate immediate treatment success and long-term disease progression for treatment-naive patients. The model analyzes both short-term and long-term costs and benefits from the perspective of the German Statutory Health Insurance. We apply the efficiency frontier method, which was suggested by German Institute for Quality and Efficiency in Health Care for cost-effectiveness analysis in Germany.ResultsThe efficiency frontier is defined by dual therapy and first generation direct-acting antiviral Boceprevir, yielding a maximum of € 1,447.69 per additional percentage point of sustained virologic response gained. Even without rebates, Sofosbuvir/Simeprevir is very close with € 1,560.13 per additional percentage point. It is both more effective and less expensive than Sofosbuvir/Ribavirin.ConclusionsIn addition to higher sustained virologic response rates, new direct-acting antivirals save long-term costs by preventing complications such as liver cirrhosis, hepatocellular carcinoma and ultimately liver transplants, thereby offsetting part of higher drug costs. Our findings are in line with the guidance published by German Society for Gastroenterology, Digestive and Metabolic Diseases, which recommends Sofosbuvir/Simeprevir for Interferon ineligible or intolerant patients.

【 授权许可】

Unknown   
© Gissel et al. 2015. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.