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PLoS One. 2015 May 14;10(5):e0126984. doi: 10.1371/journal.pone.0126984. eCollection 2015.

Cost-effectiveness analysis of sofosbuvir compared to current standard treatment in Swiss patients with chronic hepatitis C.

Author information

1
Institute of Pharmaceutical Medicine (ECPM), University of Basel, Basel, Switzerland.
2
Department of Health Sciences, Helsana Group, Zurich, Switzerland.
3
OPTUMInsight, Uxbridge, Middlesex, United Kingdom.
4
Divisions of Gastroenterology and Hepatology and of Clinical Pathology, University Hospital Geneva, Geneva, Switzerland.
5
Swiss HPB (Hepato-Pancreato-Biliary) Center and Department of Gastroenterology and Hepatology, University Hospital Zürich, Zurich, Switzerland.
6
World Health Organization (WHO), African Union, Governments, Denges VD, Switzerland.

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.

PMID:
25974722
PMCID:
PMC4431849
DOI:
10.1371/journal.pone.0126984
[Indexed for MEDLINE]
Free PMC Article

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