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Value Health Reg Issues. 2017 May;12:1-6. doi: 10.1016/j.vhri.2016.10.002. Epub 2016 Dec 24.

Assessing the Budget Impact and Economic Outcomes of the Introduction of Daclatasvir + Asunaprevir and Sofosbuvir/Ledipasvir for the Treatment of Chronic Hepatitis C Virus Infection in Japan.

Author information

1
Health Economics and Outcomes Research, Ltd., Cardiff, UK.
2
Health Economics and Outcomes Research, Ltd., Cardiff, UK. Electronic address: samantha.webster@heor.co.uk.
3
Health Economics and Outcomes Research, Bristol-Myers Squibb KK, Tokyo, Japan.
4
Health Economics and Outcomes Research, Ltd., Cardiff, UK; Swansea Centre for Health Economics, School of Human and Health Sciences, Swansea University, Swansea, UK.
5
World Wide Health Economics and Outcomes Research, Bristol-Myers Squibb Pharmaceuticals, Ltd., Princeton, NJ, USA.

Abstract

BACKGROUND:

The advent of highly efficacious, well-tolerated, all-oral direct-acting antiviral regimens has revolutionized the standard of care for patients chronically infected with hepatitis C virus. As efficacy and safety rates converge, prescribers and payers need to consider value for money.

OBJECTIVES:

To evaluate the health economic value of daclatasvir + asunaprevir versus sofosbuvir/ledipasvir via a cost-effectiveness analysis, and determine the optimal treatment considering both costs and health outcomes in Japan.

METHODS:

A previously published Markov model was used to estimate the cost-effectiveness of daclatasvir + asunaprevir compared with sofosbuvir/ledipasvir on the basis of a matching-adjusted indirect comparison of pivotal trials and modeling inputs specific to the Japanese setting. A de novo budget impact model was developed and used to predict the cost implications of differing treatment sequences.

RESULTS:

Cost-effectiveness results demonstrated minimal difference in terms of benefit (0.037 fewer QALYs and 0.014 fewer life-years with daclatasvir + asunaprevir); nevertheless, a significant difference in cost was predicted (estimated ¥2,299,700 [US $21,695] reduction with daclatasvir + asunaprevir). The budget impact analysis estimated that treatment with daclatasvir + asunaprevir is expected to be less expensive than treatment with sofosbuvir/ledipasvir (as the proportion of patients initially treated with sofosbuvir/ledipasvir increased from 0% to 100%, total costs increased from ¥206 to ¥403 billion [US $1.94 billion to US $3.80 billion]).

CONCLUSIONS:

On the basis of results from an established cost-effectiveness model and a conventional budget impact analysis, treatment with daclatasvir + asunaprevir is expected to be cost-saving compared with treatment with sofosbuvir/ledipasvir in Japan with similar health outcomes, regardless of treatment sequence.

KEYWORDS:

asunaprevir; budget impact; cost-effectiveness; daclatasvir; hepatitis C virus

PMID:
28648305
DOI:
10.1016/j.vhri.2016.10.002
[Indexed for MEDLINE]

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