Cost-effectiveness modelling of Sofosbuvir-containing regimens for chronic genotype 5 hepatitis C virus infection in South Africa
Date
2016Author
Fraser, Ilanca
Burger, Johanita
Lubbe, Martie
Dranitsaris, George
Sonderup, Mark
Metadata
Show full item recordAbstract
Background The recently launched nucleotide polymerase
inhibitor sofosbuvir represents a significant turn in
the treatment paradigm of chronic hepatitis C. While
effective, sofosbuvir is also associated with a considerable
cost.
Objective The objective of this study was to evaluate the
cost effectiveness of sofosbuvir-containing regimens in
treatment-naive patients with chronic hepatitis C virus
(HCV) genotype 5 (HCV-G5) mono-infection in South
Africa (SA).
Design We constructed a lifetime horizon decision-analytic
Markov model of the natural history of HCV infection
to evaluate the cost effectiveness of sofosbuvir–ledipasvir
(SOF/LDV) monotherapy against sofosbuvir triple therapy
(SOF-TT) (sofosbuvir ? pegylated interferon and ribavirin
[peg-INF/RBV]) and the current standard of care (SOC)
(peg-INF/RBV) for patients with chronic HCV-G5 in the
South African context. The model was populated with data
from published literature, expert opinion and South African
private sector cost data. The price modelled for sofosbuvir
was the predicted South African private sector price of
82,129.32 South African rand (R) (US$7000) for 12 weeks.
The analysis was conducted from a third-party payer
perspective.
Outcome Measures The outcome measures were discounted
and undiscounted costs (in 2015 South African
rand and US dollars) and quality-adjusted life-years
(QALYs), and incremental cost-effectiveness ratios
(ICERs).
Results Outcomes from the cost-effectiveness model
show that SOF/LDV yields the most favourable future
health economic outcomes compared with SOF-TT and the
current SOC in SA. Findings relating to the lifetime
incremental cost per QALY gained for patients infected
with HCV-G5 indicate that SOF/LDV dominated both
SOF-TT and SOC, i.e. SOF/LDV is less costly and more
effective.
Conclusion Outcomes from this analysis suggest that at a
price of R123,190 ($US10,500) for 12 weeks of SOF/LDV
might be cost effective for South African patients infected
URI
http://hdl.handle.net/10394/23182https://link.springer.com/article/10.1007%2Fs40273-015-0356-x
https://doi.org/10.1007/s40273-015-0356-x
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