Personalized cost-effectiveness of boceprevir-based triple therapy for untreated patients with genotype 1 chronic hepatitis C

Salvatore Petta, Giuseppe Cabibbo, Marco Enea, Fabio Salvatore Macaluso, Antonella Plaia, Raffaele Bruno, Antonio Gasbarrini, Savino Bruno, Antonio Craxì, Calogero Cammà

Research output: Contribution to journalArticlepeer-review

Abstract

Background: We assessed the cost-effectiveness of boceprevir-based triple therapy compared to peginterferon alpha and ribavirin dual therapy in untreated patients with genotype 1 chronic hepatitis C; patients were discriminated according to the combination of baseline plus on-treatment predictors of boceprevir-based triple therapy. Methods: Cost-effectiveness analysis performed according to data from the available published literature. The target population was composed of untreated Caucasian patients, aged 50 years, with genotype 1 chronic hepatitis C, and these were evaluated over a lifetime horizon by Markov model. The study was carried out from the perspective of the Italian National Health Service. Outcomes included discounted costs (in euro, at 2013 value), life-years gained, quality-adjusted life year, and incremental cost-effectiveness ratio. The robustness of the results was evaluated by multivariable probabilistic sensitivity analyses. Results: According to the baseline predictors of sustained virological response (genotype 1b, low viral load, fibrosis F0-F3, and body mass index) and the 1. Log drop of HCV-RNA after the dual therapy lead-in period, boceprevir was cost-effective in different patient profiles. Conclusions: In untreated genotype 1b chronic hepatitis C patients, the cost-effectiveness of boceprevir-based triple therapy widely ranges according to different profiles of sustained virological response predictors, allowing optimization and personalization of triple therapy.

Original languageEnglish
Pages (from-to)936-942
Number of pages7
JournalDigestive and Liver Disease
Volume46
Issue number10
DOIs
Publication statusPublished - 2014

Keywords

  • Boceprevir
  • Cost-effectiveness
  • Peg-interferon

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology
  • Medicine(all)

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