Table 1.
Cost of HCV treatment by component type among HIV-infected individuals in Myanmar, with the ‘Observed MSF’ treatment protocol and proposed alternative protocols
| HCV visit costs per patient | HCV laboratory costs per patient | DAA costs per patient | HCV coordination costs per patient | Total HCV treatment costs per patient | |
| Observed MSF intervention* | |||||
| Non-cirrhotic | 186.60 (95% CI 158.65 to 292.94) | 420.80 (95% CI 194.80 to 718.94) | 523.53 (95% CI 411.60 to 663.81) | 97.60 (95% CI 82.74 to 153.66) |
1228.53 (95% CI 847.79 to 1829.35) |
| Cirrhotic | 270.47 (95% CI 225.45 to 419.17) | 436.73 (95% CI 251.62 to 697.04) | 1122.01 (95% CI 711.58 to 1349.37) | 141.84 (95% CI 118.20 to 220.15) | 1971.05 (95% CI 1306.85 to 2685.72) |
| MSF with updated DAA costs† | |||||
| Non-cirrhotic | 186.60 (95% CI 158.65 to 292.94) | 420.80 (95% CI 194.80 to 718.94) | 183.69 (95% CI 169.03 to 198.35) |
97.60 (95% CI 82.74 to 153.66) |
888.69 (95% CI 742.41 to 827.62) |
| Cirrhotic | 270.47 (95% CI 225.45 to 419.17) | 436.73 (95% CI 251.62 to 697.04) | 453.02 (95% CI 413.51 to 492.53) |
141.84 (95% CI 118.20 to 220.15) |
1302.06 (95% CI 1102.84 to 1219.49) |
| Simplified MoH‡ | |||||
| Non-cirrhotic | 80.92 | 216.33 | 120 | – | 417.25 |
| Cirrhotic | 89.54 | 271.25 | 240 | – | 600.79 |
*‘Observed MSF intervention’ presents summary data from observational study, including 2017 DAA prices.
†‘MSF with updated DAA costs’ estimates costs with updated DAA prices for quality-assured generic DAAs negotiated in 2018.
‡‘Simplified MoH’ strategy estimates costs with generic DAAs and a proposed simplified protocol (figure 1), with local staff costs and no overheads. The 95% CIs are presented for the observed cost data reflecting patient variations in observed costs. For estimations of costs using updated cost data or simplified strategies, patients were assumed to adhere to the exact clinical schedule (see figure 1) and so no uncertainty is provided. Non-cirrhotic: METAVIR F0–F3, cirrhotic: F4 as measured by transient elastography.
DAA, direct-acting antiviral; HCV, hepatitis C virus; MoH, Ministry of Health; MSF, Médecins sans Frontières.