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Clinical Trial
. 2015 Apr;22(4):376-83.
doi: 10.1111/jvh.12311. Epub 2014 Sep 15.

Cost-effectiveness of sofosbuvir in the treatment of patients with hepatitis C

H Leleu  1 , M Blachier, I Rosa
Affiliations
Clinical Trial

Cost-effectiveness of sofosbuvir in the treatment of patients with hepatitis C

H Leleu et al. J Viral Hepat. 2015 Apr.

Abstract

In France, 190,306 patients were suffering from chronic hepatitis C in 2012. These patients have a decreased life expectancy and are susceptible to complications associated with chronic hepatitis. Current treatments are poorly tolerated and their effectiveness varies depending on the genotype of the virus. Sofosbuvir, a new class of treatment, has demonstrated in five phase III trials sustained viral response (SVR) rates of over 90% across genotypes, higher than current treatments and has a tolerance profile similar to placebo. The objective was to determine the cost-effectiveness of using sofosbuvir in the treatment of chronic HCV infection. A Markov model was used to compare treatment strategies with and without sofosbuvir. The model simulated the natural history of HCV infection. SVR rates were based on data from clinical trials. Utilities associated with different stages of disease were based on data from the literature. French direct medical costs were used. Price for sofosbuvir was the price used in the early access program for severe fibrosis stages. The incremental cost-effectiveness ratio for sofosbuvir versus current reference treatments was € 16,278/QALY and varied from 40,000 €/QALY for F0 stages to 12,080 €/QALY for F4 stages. The sensitivity analyses carried out confirmed the robustness of this result. Sofosbuvir is a cost-effective treatment option for patients with hepatitis C.

Keywords: France; cost-benefit analysis; healthcare costs; hepatitis C; sofosbuvir.

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Figures

Fig 1
Fig 1
Markov tree.
Fig 2
Fig 2
Deterministic sensitivity analysis TP: transition probabilities, SVR: sustained viral response, HCC: Hepatocarcinoma, ICER: Incremental Cost–Effectiveness Ratio.
Fig 3
Fig 3
Acceptability curve.
See this image and copyright information in PMC

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