TY - JOUR
T1 - Cost-effectiveness analysis of sofosbuvir plus ribavirin in patients with genotype 2 chronic hepatitis C
T2 - An analysis with real world outcomes from a multicentre cohort in Japan
AU - Igarashi, Ataru
AU - Furusyo, Norihiro
AU - Ogawa, Eiichi
AU - Nomura, Hideyuki
AU - Dohmen, Kazufumi
AU - Higashi, Nobuhiko
AU - Takahashi, Kazuhiro
AU - Kawano, Akira
AU - Azuma, Koichi
AU - Satoh, Takeaki
AU - Nakamuta, Makoto
AU - Koyanagi, Toshimasa
AU - Kato, Masaki
AU - Shimoda, Shinji
AU - Kajiwara, Eiji
AU - Hayashi, Jun
N1 - Funding Information:
Competing interests AI received the research grants from Gilead Sciences K.K.,
Funding Information:
for this study. He received grants from AbbVie GK., grants from Abbott Japan Inc., grants from Beckton Dickinson and Company, personal fees from Chugai Pharmaceuticals Inc., personal fees from Astellas Pharma Inc., grants from Eli Lilly Japan K.K., personal fees from CSL Behring Japan Inc., personal fees from Fuji film Inc., personal fees from Takeda Pharmaceutical Inc., grants from Milliman Inc., grants from Creativ-Ceuticals Inc., grants from PFIZER INC., grants from Intuitive Surgical G.K., personal fees from Sanofi Japan Inc., grants from Terumo corporation, outside the submitted work.
Funding Information:
Funding This study was funded by Gilead Sciences.
Publisher Copyright:
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2019/6/1
Y1 - 2019/6/1
N2 - Objectives A number of publications have demonstrated the cost-effectiveness of sofosbuvir plus ribavirin (SOF+RBV) compared with the former standard therapy with interferon (IFN)-containing regimens. Unlike these cost-effective analyses, where efficacy parameters were obtained from registration trials for drug approval, this analysis is a cost-effectiveness analysis of SOF+RBV for genotype (GT) 2 non-cirrhosis (NC) and compensated cirrhosis (CC) patients using efficacy parameters obtained from a multicentre cohort study (Kyushu University Liver Disease Study; KULDS) in Kyushu area in Japan in order to reflect real-world clinical practice in Japan. Method A Markov model followed 10 000 patients (62 years old) over their lifetime. Four populations were followed: Treatment-naïve (TN)-NC, treatment-experienced (TE)-NC, TN-CC and TE-CC. Comparators were Peg-IFNα2b+RBV for TN-NC and CC patients and telaprevir (TVR)+Peg-IFNα2b+RBV for TE-NC patients. The sustained virological response (SVR) rates of SOF+RBV were taken from KULDS and those of comparators were obtained from systematic literature reviews. There were nine states (NC, CC, decompensated cirrhosis [DC], hepatocellular carcinoma [HCC], SVR [NC], SVR [CC], liver transplantation [LT], post-LT and death) in this model, and an increase in the progression rate to HCC due to ageing was also considered. The analysis was conducted from the perspective of a public healthcare payer, and a discount rate of 2% was set for both cost and effectiveness. Results Incremental cost-effectiveness ratios (ICERs) of SOF+RBV versus Peg-IFNα2b+RBV were ¥323 928 /quality-Adjusted life year (QALY) for TN-NC patients, ¥92 256/QALY for TN-CC patients and ¥1 519 202/QALY for TE-CC patients. The ICER of SOF+RBV versus TVR+Peg-IFNα2b+RBV was ¥849 138/QALY for TE-NC patients. The robustness of the results was determined by sensitivity analysis. Conclusions The results of this analysis strongly demonstrate the robustness of our previous findings that SOF+RBV regimens are cost-effective in the real world and clinical trial settings for Japanese GT2 NC and CC patients.
AB - Objectives A number of publications have demonstrated the cost-effectiveness of sofosbuvir plus ribavirin (SOF+RBV) compared with the former standard therapy with interferon (IFN)-containing regimens. Unlike these cost-effective analyses, where efficacy parameters were obtained from registration trials for drug approval, this analysis is a cost-effectiveness analysis of SOF+RBV for genotype (GT) 2 non-cirrhosis (NC) and compensated cirrhosis (CC) patients using efficacy parameters obtained from a multicentre cohort study (Kyushu University Liver Disease Study; KULDS) in Kyushu area in Japan in order to reflect real-world clinical practice in Japan. Method A Markov model followed 10 000 patients (62 years old) over their lifetime. Four populations were followed: Treatment-naïve (TN)-NC, treatment-experienced (TE)-NC, TN-CC and TE-CC. Comparators were Peg-IFNα2b+RBV for TN-NC and CC patients and telaprevir (TVR)+Peg-IFNα2b+RBV for TE-NC patients. The sustained virological response (SVR) rates of SOF+RBV were taken from KULDS and those of comparators were obtained from systematic literature reviews. There were nine states (NC, CC, decompensated cirrhosis [DC], hepatocellular carcinoma [HCC], SVR [NC], SVR [CC], liver transplantation [LT], post-LT and death) in this model, and an increase in the progression rate to HCC due to ageing was also considered. The analysis was conducted from the perspective of a public healthcare payer, and a discount rate of 2% was set for both cost and effectiveness. Results Incremental cost-effectiveness ratios (ICERs) of SOF+RBV versus Peg-IFNα2b+RBV were ¥323 928 /quality-Adjusted life year (QALY) for TN-NC patients, ¥92 256/QALY for TN-CC patients and ¥1 519 202/QALY for TE-CC patients. The ICER of SOF+RBV versus TVR+Peg-IFNα2b+RBV was ¥849 138/QALY for TE-NC patients. The robustness of the results was determined by sensitivity analysis. Conclusions The results of this analysis strongly demonstrate the robustness of our previous findings that SOF+RBV regimens are cost-effective in the real world and clinical trial settings for Japanese GT2 NC and CC patients.
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U2 - 10.1136/bmjopen-2018-023405
DO - 10.1136/bmjopen-2018-023405
M3 - Article
C2 - 31221866
AN - SCOPUS:85067949892
VL - 9
JO - BMJ Open
JF - BMJ Open
SN - 2044-6055
IS - 6
M1 - e023405
ER -
