Estimating the cost-effectiveness of daclatasvir plus asunaprevir in difficult to treat Japanese patients chronically infected with hepatitis C genotype 1b

摘要: Aim Standard of care for chronic hepatitis C in Japan is currently a pegylated interferon (IFN)-α + ribavirin (PR)-based regimen, notably associated with efficacy and tolerability issues. The advent novel direct-acting antivirals (DAA) has provided more efficacious better tolerated treatments. This study investigated the cost-effectiveness daclatasvir + asunaprevir (DCV + ASV) DAA regimen patients infected virus (HCV) genotype 1b who had previously not responded to or were ineligible IFN-containing regimens. Methods A cost–utility analysis using an established Markov model compared DCV + ASV simeprevir + PR (SMV + PR), telaprevir + PR (TVR + PR) no treatment Japanese-specific inputs, costs utility values discounted at 2%. A cohort was simulated until death predicted quality-adjusted life-years (QALY) estimated. subgroup DCV resistance conducted. Results In all scenarios, be dominant over comparator; namely, increased QALY gains decreased cost. In treated during stage, cost reductions ¥1 057 288–2 619 206, compensated cirrhosis (CC) ¥1 032 224–2 531 930. 0.749–2.609 0.874–3.043, respectively. Results improved when considering without resistance. Conclusion Cost-effectiveness conclusions are similar CC disease stages, expected cost-saving versus standard HCV have failed prior therapy IFN-ineligible/intolerant.