Table 4.
Cost-Effectiveness of Treatment for Hepatitis C Virus Infection Among Genotype 1a and 1b Cirrhotic Patients
| Treatment Strategy | Cost, $ | Incremental Cost, $ | QALYs | Incremental QALYs | ICER, $/QALY | SVR, % | Nondiscounted Cost/10 000 Patients, Billion $ |
|---|---|---|---|---|---|---|---|
| Genotype 1a, Treatment-Naive | |||||||
| No treatment | 99 000 | - | 4.9 | - | - | - | 0.44 |
| PEG/RBV 48 weeks | 158 000 | 59 600 | 7.0 | 2.1 | Dominateda | 23.5 | 0.91 |
| PEG/RBV/SMV 24 weeks | 197 000 | 38 200 | 9.9 | 2.9 | Dominateda | 53.6 | 1.12 |
| PTV/r/OBV/DSV/RBV 12 weeks | 245 000 | 146 000 | 13.7 | 8.9 | 16 500 | 92.7 | 1.36 |
| PEG/RBV/SOF 12 weeks | 252 000 | 6900 | 12.3 | −1.4 | Dominateda | 78.6 | 1.52 |
| SOF/LDV 12 weeks | 255 000 | 10 000 | 14.0 | 0.2 | 43 000 | 95.1 | 1.45 |
| DCV/SOF 24 weeks | 453 000 | 198 000 | 14.1 | 0.1 | 2 370 000 | 96.9 | 3.46 |
| Genotype 1a, Treatment-Experienced | |||||||
| No treatment | 99 000 | - | 4.7 | - | - | - | 0.47 |
| PEG/RBV/SOF 12 weeks | 246 000 | 147 000 | 11.5 | 6.8 | Dominateda | 78.3 | 1.54 |
| SOF/LDV/RBV 12 weeks | 253 000 | 154 000 | 12.9 | 8.2 | 18 700 | 94.2 | 1.53 |
| PTV/r/OBV/DSV/RBV 24 weeks | 315 000 | 62 100 | 12.8 | −0.1 | Dominateda | 94.0 | 2.17 |
| SMV/SOF 12 weeks | 317 000 | 64 500 | 12.5 | −0.4 | Dominateda | 90.0 | 2.21 |
| SOF/LDV 24 weeks | 334 000 | 81 000 | 13.0 | 0.2 | 520 000 | 96.8 | 2.34 |
| DCV/SOF/RBV 24 weeks | 453 000 | 119 000 | 13.0 | 0.0 | Dominateda | 96.7 | 3.56 |
| Genotype 1b, Treatment-Naive | |||||||
| No treatment | 99 000 | - | 4.9 | - | - | - | 0.44 |
| PEG/RBV 48 weeks | 158 000 | 59 400 | 7.0 | 2.10 | Dominateda | 23.1 | 0.91 |
| PEG/RBV/SMV 24 weeks | 205 000 | 46 800 | 10.8 | 3.80 | Dominateda | 62.4 | 1.15 |
| PTV/r/OBV/DSV/RBV 12 weeks | 248 000 | 149 000 | 14.2 | 9.27 | 16 100 | 97.0 | 1.37 |
| PEG/RBV/SOF 12 weeks | 252 000 | 4000 | 12.4 | −1.79 | Dominateda | 78.5 | 1.52 |
| SOF/LDV 12 weeks | 255 000 | 7100 | 14.0 | −0.17 | Dominateda | 95.3 | 1.45 |
| DCV/SOF 24 weeks | 453 000 | 205 000 | 14.1 | −0.10 | Dominateda | 96.9 | 3.46 |
| Genotype 1b, Treatment-Experienced | |||||||
| No treatment | 98 000 | - | 4.6 | - | - | - | 0.46 |
| PTV/r/OBV/DSV/RBV 12 weeks | 239 000 | 141 000 | 13.0 | 8.40 | 16 800 | 96.3 | 1.38 |
| PEG/RBV/SOF 12 weeks | 245 000 | 5800 | 11.4 | −1.59 | Dominateda | 78.3 | 1.54 |
| SOF/LDV/RBV 12 weeks | 252 000 | 12 600 | 12.8 | −0.21 | Dominateda | 94.0 | 1.52 |
| SMV/SOF 12 weeks | 319 000 | 79 700 | 13.1 | 0.10 | 828 000 | 97.4 | 2.19 |
| SOF/LDV 24 weeks | 332 000 | 13 500 | 13.0 | −0.16 | Dominateda | 96.4 | 2.34 |
| DCV/SOF/RBV 24 weeks | 451 000 | 132 000 | 12.9 | −0.18 | Dominateda | 96.2 | 3.56 |
Abbreviations: DCV, daclatasvir; DSV, dasabuvir; F2, fibrosis stage F2; HCV, hepatitis C virus; ICER, incremental cost-effectiveness ratio; LDV, ledipasvir; OBV, ombitasvir; PEG, pegylated-interferon; PTV, paritaprevir; QALY, quality-adjusted life year; r, ritonavir; RBV, ribavirin; SMV, simeprevir; SOF, sofosbuvir; SVR, sustained virologic response.
(NOTE: All values are mean per-person values based on Monte-Carlo simulations of 1000000 individuals. Nondiscounted cost per 10000 patients is calculated over 5 years. Cost-effectiveness ratios may not match previous columns due to rounding.)
Dominated = strategy is more costly and less effective than a competing strategy or strategies with an ICER greater than that of a more effective strategy.