Year 2018 / Volume 110 / Number 10
Original
Economic evaluation of a population strategy for the treatment of chronic hepatitis C with direct-acting antivirals

621-628

DOI: 10.17235/reed.2018.5605/2018

Javier Mar, Oliver Ibarrondo, Iván Martínez-Baz, Regina Juanbeltz, Ramón San Miguel, Itziar Casado, Arantzazu Arrospide, Jesús Castilla,

Abstract
The high initial cost of antivirals against hepatitis C prompted development of the "Strategic Plan for Tackling Chronic Hepatitis C in the Spanish National Health System”. The objective of this study was the economic evaluation of the first two years of its application in Navarre, Spain. The change in the natural history of hepatitis C produced by the sustained virological response (SVR) was compared to an alternative without treatment and modeled with patient-level data. By means of a discrete events simulation model, the cost-effectiveness and the budget impact analysis of the treatment program were measured from the perspective of the Navarre Health Service. Of 656 patients treated, 98% had SVR. The average cost of the treatments was 18,743 euros per patient. The incremental cost-effectiveness ratio (ICER) with discount was 5,346 euros per quality-adjusted life years, which became more efficient as the stage of fibrosis increased until it reached levels of dominance in stage 4 fibrosis. The associated costs for chronic liver disease decreased as the benefit of the treatment was expressed. The implementation of the Strategic Plan is cost-effective, with an ICER well below the threshold, since the cost of treatment is largely compensated by savings in long-term health expenditure. The budgetary impact foresees a net saving from the third year on. The two key parameters were the decrease in the price of the treatment and the SVR in nearly 100% of the patients.
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Mar J, Ibarrondo O, Martínez-Baz I, Juanbeltz R, San Miguel R, Casado I, et all. Economic evaluation of a population strategy for the treatment of chronic hepatitis C with direct-acting antivirals. 5605/2018


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Publication history

Received: 16/03/2018

Accepted: 17/04/2018

Online First: 23/07/2018

Published: 01/10/2018

Article revision time: 26 days

Article Online First time: 129 days

Article editing time: 199 days


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