Cost-effectiveness analysis with direct-acting antivirals in a cohort of HCV-infected inmates in Italy

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Title Cost-effectiveness analysis with direct-acting antivirals in a cohort of HCV-infected inmates in Italy
 
Creator Ravasio, Roberto
Lucania, Luciano
Ranieri, Roberto
Dominguez, Raquel
 
Description Objective: To evaluate the cost-effectiveness of a strategy based on direct-acting antivirals (DAAs) versus no drug strategy in HCV-infected inmates, from the perspective of the Italian National Health System (iNHS).
Methods: A previous Markov model was adapted to the Italian setting to evaluate the direct medical costs and health outcomes (quality-adjusted life years, QALY) throughout the life of HCV-infected inmates. Epidemiological data, patient characteristics (genotype, METAVIR classification), DAAs sustained virological response (SVR), annual likelihood of transition, treatment costs and utilities were gathered from the literature. The DAAs strategy included the administration of elbasvir/grazoprevir or sofosbuvir/velpatasvir or glecaprevir/pibrentasvir. Direct medical costs and QALYs were discounted at a 3.0% annual rate. Cost-effectiveness was evaluated as incremental cost-effectiveness ratio (€, 2019) per QALY gained. A deterministic sensitivity analysis (DSA) was performed.
Results: Over a lifetime horizon, the DAAs strategy showed higher health costs per patient compared to no drugs strategy in the base-case analysis (€ 42,571 vs. € 26,119). However, it was associated with an increase of QALYs gained (21.14 vs. 15.67), showing an incremental cost-effectiveness ratio of € 3,010 per QALY. The sensitivity analysis confirmed the base-case results.
Conclusions: Extending the DAAs treatment to HCV-infected inmates was estimated to be cost effective from the perspective of the Italian NHS, regardless genotype and METAVIR classification. (HTA & Market Access)
 
Publisher AboutScience srl - Piazza Duca d'Aosta 12 - 20124 Milano MI (Italy)
 
Date 2020-12-23
 
Type info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
Original Research Article
 
Format application/pdf
application/epub+zip
text/html
 
Identifier https://journals.aboutscience.eu/index.php/aboutopen/article/view/2190
10.33393/ao.2020.2190
 
Source AboutOpen; Vol 7 No 1 (2020): January - December 2020; 103-111
AboutOpen; V. 7 N. 1 (2020): January - December 2020; 103-111
2465-2628
 
Language eng
 
Relation https://journals.aboutscience.eu/index.php/aboutopen/article/view/2190/2231
https://journals.aboutscience.eu/index.php/aboutopen/article/view/2190/2232
https://journals.aboutscience.eu/index.php/aboutopen/article/view/2190/2233
 
Rights Copyright (c) 2020 The authors
http://creativecommons.org/licenses/by-nc/4.0
 

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