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Cost-Effectiveness Analysis of Sofosbuvir Compared to Current Standard Treatment in Swiss Patients with Chronic Hepatitis C

Author

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  • Alena M Pfeil
  • Oliver Reich
  • Ines M Guerra
  • Sandrine Cure
  • Francesco Negro
  • Beat Müllhaupt
  • Daniel Lavanchy
  • Matthias Schwenkglenks

Abstract

In clinical trials, sofosbuvir showed high antiviral activity in patients infected with hepatitis C virus (HCV) across all genotypes. We aimed to determine the cost-effectiveness of sofosbuvir-based treatment compared to current standard treatment in mono-infected patients with chronic hepatitis C (CHC) genotypes 1–4 in Switzerland. Cost-effectiveness was modelled from the perspective of the Swiss health care system using a lifetime Markov model. Incremental cost-effectiveness ratios (ICERs) used an endpoint of cost per quality-adjusted life year (QALY) gained. Treatment characteristics, quality of life, and transition probabilities were obtained from published literature. Country-specific model inputs such as patient characteristics, mortality and costs were obtained from Swiss sources. We performed extensive sensitivity analyses. Costs and effects were discounted at 3% (range: 0–5%) per year. Sofosbuvir-containing treatment in mixed cohorts of cirrhotic and non-cirrhotic patients with CHC genotypes 1–4 showed ICERs between CHF 10,337 and CHF 91,570 per QALY gained. In subgroup analyses, sofosbuvir dominated telaprevir- and boceprevir-containing treatment in treatment-naïve genotype 1 cirrhotic patients. ICERs of sofosbuvir were above CHF 100,000 per QALY in treatment-naïve, interferon eligible, non-cirrhotic patients infected with genotypes 2 or 3. In deterministic and probabilistic sensitivity analyses, results were generally robust. From a Swiss health care system perspective, treatment of mixed cohorts of cirrhotic and non-cirrhotic patients with CHC genotypes 1–4 with sofosbuvir-containing treatment versus standard treatment would be cost-effective if a threshold of CHF 100,000 per QALY was assumed.

Suggested Citation

  • Alena M Pfeil & Oliver Reich & Ines M Guerra & Sandrine Cure & Francesco Negro & Beat Müllhaupt & Daniel Lavanchy & Matthias Schwenkglenks, 2015. "Cost-Effectiveness Analysis of Sofosbuvir Compared to Current Standard Treatment in Swiss Patients with Chronic Hepatitis C," PLOS ONE, Public Library of Science, vol. 10(5), pages 1-20, May.
    • Handle: RePEc:plo:pone00:0126984
    DOI: 10.1371/journal.pone.0126984
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    References listed on IDEAS

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    1. Don Husereau & Michael Drummond & Stavros Petrou & Chris Carswell & David Moher & Dan Greenberg & Federico Augustovski & Andrew Briggs & Josephine Mauskopf & Elizabeth Loder, 2013. "Consolidated Health Economic Evaluation Reporting Standards (CHEERS) Statement," PharmacoEconomics, Springer, vol. 31(5), pages 361-367, May.
    2. James D. Chambers & Peter J. Neumann & Martin J. Buxton, 2010. "Does Medicare Have an Implicit Cost-Effectiveness Threshold?," Medical Decision Making, , vol. 30(4), pages 14-27, July.
    3. McCabe, C & Claxton, K & Culyer, AJ, 2008. "The NICE Cost-Effectiveness Threshold: What it is and What that Means," MPRA Paper 26466, University Library of Munich, Germany.
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    1. Nathalie Vernaz & François Girardin & Nicolas Goossens & Urs Brügger & Marco Riguzzi & Arnaud Perrier & Francesco Negro, 2016. "Drug Pricing Evolution in Hepatitis C," PLOS ONE, Public Library of Science, vol. 11(6), pages 1-12, June.
    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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