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Economic Evaluation of Hepatitis C Treatment Extension to Acute Infection and Early-Stage Fibrosis Among Patients Who Inject Drugs in Developing Countries: A Case of China

Author

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  • Yin Liu

    (Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
    Sun Yat-sen Center for Migrant Health Policy, Sun Yat-Sen University, Guangzhou 510080, China
    These authors contributed equally to the work.)

  • Hui Zhang

    (Department of Health Policy and Management, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
    These authors contributed equally to the work.)

  • Lei Zhang

    (China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710000, China
    Melbourne Sexual Health Center, Alfred Health, Melbourne VIC 3053, Australia
    Central Clinical School, Faculty of Medicine, Monash University, Melbourne, VIC 3800, Australia
    Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China)

  • Xia Zou

    (Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
    Sun Yat-sen Center for Migrant Health Policy, Sun Yat-Sen University, Guangzhou 510080, China)

  • Li Ling

    (Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
    Sun Yat-sen Center for Migrant Health Policy, Sun Yat-Sen University, Guangzhou 510080, China)

Abstract

We aimed to assess the cost-effectiveness of (1) treating acute hepatitis C virus (HCV) vs. deferring treatment until the chronic phase and (2) treating all chronic patients vs. only those with advanced fibrosis; among Chinese genotype 1b treatment-naïve patients who injected drugs (PWID), using a combination Daclatasvir (DCV) plus Asunaprevir (ASV) regimen and a Peg-interferon (PegIFN)-based regimen, respectively. A decision-analytical model including the risk of HCV reinfection simulated lifetime costs and quality-adjusted life-years (QALYs) of three treatment timings, under the DCV+ASV and PegIFN regimen, respectively: Treating acute infection (“Treat at acute”), treating chronic patients of all fibrosis stages (“Treat at F0 (no fibrosis)”), treating only advanced-stage fibrosis patients (“Treat at F3 (numerous septa without cirrhosis)”). Incremental cost-effectiveness ratios (ICERs) were used to compare scenarios. “Treat at acute” compared with “Treat at F0” was cost-saving (cost: DCV+ASV regimen—US$14,486.975 vs. US$16,224.250; PegIFN-based regimen—US$19,734.794 vs. US$22,101.584) and more effective (QALY: DCV+ASV regimen—14.573 vs. 14.566; PegIFN-based regimen—14.148 vs. 14.116). Compared with “Treat at F3”; “Treat at F0” exhibited an ICER of US$3780.20/QALY and US$15,145.98/QALY under the DCV+ASV regimen and PegIFN-based regimen; respectively. Treatment of acute HCV infection was highly cost-effective and cost-saving compared with deferring treatment to the chronic stage; for both DCV+ASV and PegIFN-based regimens. Early treatment for chronic patients with DCV+ASV regimen was highly cost-effective.

Suggested Citation

  • Yin Liu & Hui Zhang & Lei Zhang & Xia Zou & Li Ling, 2020. "Economic Evaluation of Hepatitis C Treatment Extension to Acute Infection and Early-Stage Fibrosis Among Patients Who Inject Drugs in Developing Countries: A Case of China," IJERPH, MDPI, vol. 17(3), pages 1-13, January.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:3:p:800-:d:313646
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    References listed on IDEAS

    as
    1. Daniëla K van Santen & Anneke S de Vos & Amy Matser & Sophie B Willemse & Karen Lindenburg & Mirjam E E Kretzschmar & Maria Prins & G Ardine de Wit, 2016. "Cost-Effectiveness of Hepatitis C Treatment for People Who Inject Drugs and the Impact of the Type of Epidemic; Extrapolating from Amsterdam, the Netherlands," PLOS ONE, Public Library of Science, vol. 11(10), pages 1-18, October.
    2. Guo-Feng Chen & Lai Wei & Jing Chen & Zhong-Ping Duan & Xiao-Guang Dou & Qing Xie & Wen-Hong Zhang & Lun-Gen Lu & Jian-Gao Fan & Jun Cheng & Gui-Qiang Wang & Hong Ren & Jiu-Ping Wang & Xing-Xiang Yang, 2016. "Will Sofosbuvir/Ledipasvir (Harvoni) Be Cost-Effective and Affordable for Chinese Patients Infected with Hepatitis C Virus? An Economic Analysis Using Real-World Data," PLOS ONE, Public Library of Science, vol. 11(6), pages 1-13, June.
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