Budget impact analysis of boceprevir and telaprevir for the treatment of hepatitis C genotype 1 infection

Abstract

Background: Boceprevir and telaprevir have recently showed dramatically better treatment outcomes than conventional PEGylated interferon plus ribavirin for the treatment of hepatitis C virus genotype 1, but the average cost per patient is unknown.

Methods: In the UK context, we performed a budget impact analysis to estimate the average per patient cost of adding boceprevir or telaprevir to PEGylated interferon plus ribavirin therapy. We considered both standard-duration therapy and response-guided therapy regimens of boceprevir and telaprevir for treatment-naïve and treatment-experienced patients. Our model utilized monthly discontinuation rates. We built a Bayesian Markov model to account for uncertainty associated with the clinical input and cost data.

Results: The total average cost of response-guided therapy with boceprevir is £22,850 and £25,060 for treatment-naïve and treatment-experienced patients, respectively. By comparison, the total average cost of response-guided therapy with telaprevir was £29,930 and £31,880 for treatment-naïve and treatment-experienced patients, respectively, whereas the total average cost of standard-duration boceprevir is £34,680 and £34,350 and for telaprevir was £32,530 and £31,680 for treatment-naïve and treatment experienced patients, respectively.

Conclusion: Our results demonstrate that response-guided therapy with boceprevir is notably less costly than response-guided therapy with telaprevir. Our results also suggest that the standard treatment duration of boceprevir is slightly more costly than the standard treatment duration of telaprevir.

Keywords: boceprevir; budget impact analysis; hepatitis C; telaprevir.

Figure 1

Average cumulative cost per patient treated with response-guided therapy. Abbreviation: SOC, standard of care.

Figure 1

Average cumulative cost per patient treated with response-guided therapy. Abbreviation: SOC, standard of care.

Figure 2

Average cumulative cost per patient treated with standard-duration therapy. Abbreviation: SOC, standard of care.

Figure 3

Cost per sustained virologic response for response-guided therapy (A) and standard-duration therapy (B). Abbreviation: SOC, standard of care.