Productivity improvements in hepatitis C treatment: impact on efficacy, cost, cost-effectiveness and quality of life

Abstract

Objective: The treatment of chronic hepatitis C has advanced considerably during the past 15 years. The aim of this study was to evaluate the impact of different key developments from a health-economic perspective.

Material and methods: Costs and health-related quality-of-life data from a follow-up of Swedish patients treated for hepatitis C in clinical practice were used together with clinical trial data and natural history data in order to create a mathematical model that could be used to evaluate the advancement in hepatitis C therapy. The efficacy of treatment, costs and cost-effectiveness were evaluated for both current as well as proposed treatment strategies. A sensitivity analysis was used to assess how results were affected when key variables changed.

Results: Current genotype-guided pegylated interferon and ribavirin is a cost-effective treatment strategy. A proposed treatment strategy involving a reduction in the length of treatment for certain patient subgroups with genotypes 1, 2 and 3, as well as an increase in the length of treatment for patients with genotype 1 and slow virological response was estimated to be a cost-effective future treatment alternative. These results were insensitive to changes in costs and risks associated with chronic hepatitis.

Conclusion: Although the costs for treatment of hepatitis C have increased significantly over the past decade, the improvements have provided the health-care system with cost-effective options in the treatment of patients with chronic hepatitis C.