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Estimating cost-effectiveness associated with all-oral regimen for chronic hepatitis C in China

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  • Hai Chen
  • Lijun Chen

Abstract

Background: All-oral regimens are associated with higher effectiveness and shorter treatment duration for chronic hepatitis C. Given its superior effect and enormous patients in China, clinicians or patients may be compelled to consider delaying treatment for all-oral regimen. Objective: To estimate cost-effectiveness of delaying treatment for all-oral regimen in the subsequent years under different assumptions about their price and efficacy compared with standard of care in China. Methods: A state-transition Markov model was developed to estimate lifetime costs and quality-adjusted life years (QALYs). Incremental cost-effectiveness ratio (ICER) and net monetary benefit (NB) were calculated. And sensitivity analyses were also performed to assess the impact of uncertainty. Results: For treatment naive patients with Genotype 1, immediate treatment with all-oral regimen under assumed cost and efficacy at present was cost-effective compared with peginterferon α-2a (PegIFN) regimen at present with an ICER of $12536 per QALY gained and a positive NB of $6832 at a willingness-to-pay threshold of $21209. And it was more than 95% likely to be cost-effective if weekly drug cost was less than $1000. Moreover, patients delaying treatment for all-oral regimen in the 1st year were associated with increase in QALYs of 0.62 and increase in cost of $10114 compared with initiating PegIFN regimen at present, which resulted in a positive NB of $3115. Conclusion: From a payer perspective, all-oral regimen is associated with good long-term health and economic benefit for treatment-naive patients infected with HCV genotype 1. Particularly, if all-oral regimen would become available at lower price in the future, delaying treatment for all-oral regimen may be a good choice for patients in China.

Suggested Citation

  • Hai Chen & Lijun Chen, 2017. "Estimating cost-effectiveness associated with all-oral regimen for chronic hepatitis C in China," PLOS ONE, Public Library of Science, vol. 12(4), pages 1-15, April.
  • Handle: RePEc:plo:pone00:0175189
    DOI: 10.1371/journal.pone.0175189
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    References listed on IDEAS

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    1. Alastair Heffernan & Yanling Ma & Shevanthi Nayagam & Polin Chan & Zhongdan Chen & Graham S Cooke & Yan Guo & Chuntao Liu & Mark Thursz & Wanyue Zhang & Xiaobing Zhang & Xiujie Zhang & Manhong Jia & T, 2021. "Economic and epidemiological evaluation of interventions to reduce the burden of hepatitis C in Yunnan province, China," PLOS ONE, Public Library of Science, vol. 16(1), pages 1-17, January.
    2. Yun Lu & Xiuze Jin & Cheng-a-xin Duan & Feng Chang, 2018. "Cost-effectiveness of daclatasvir plus asunaprevir for chronic hepatitis C genotype 1b treatment-naïve patients in China," PLOS ONE, Public Library of Science, vol. 13(4), pages 1-12, April.

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