Daclatasvir combined with asunaprevir is a cost-effective and cost-saving treatment for hepatitis C infection in China

J Comp Eff Res. 2018 Aug;7(8):785-795. doi: 10.2217/cer-2018-0005. Epub 2018 Jun 4.

Abstract

Aim: To evaluate the cost-effectiveness of the novel all-oral direct-acting antiviral regimen daclatasvir + asunaprevir (DUAL), versus interferon-based regimens for the treatment of chronic hepatitis C virus genotype 1b infection. Methods: Inputs for a lifetime Markov model were sourced from clinical trials and published literature. Outputs include disease management costs, life expectancy, quality-adjusted life-years and cost-effectiveness. Sensitivity analyses assessed the drivers of cost-effectiveness and sustained virologic response thresholds at which DUAL is cost-saving. Results: DUAL was associated with discounted incremental quality-adjusted life-years of 1.29-3.85 and incremental life-years of 0.85-2.59 per patient, with discounted lifetime cost savings of USD$1415-8525. Associated sustained virologic response rates could fall to 45.1-84.8%, while remaining dominant. Conclusion: Treatment with DUAL provides significant clinical benefit, while accruing lower lifetime costs.

Keywords: cost–effectiveness; daclatasvir + asunaprevir; hepatitis C.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antiviral Agents / administration & dosage
  • Antiviral Agents / economics
  • Antiviral Agents / therapeutic use*
  • China
  • Cost-Benefit Analysis
  • Drug Therapy, Combination
  • Genotype
  • Health Expenditures
  • Health Resources / economics
  • Health Resources / statistics & numerical data
  • Hepatitis C, Chronic / drug therapy*
  • Humans
  • Imidazoles / administration & dosage
  • Imidazoles / economics
  • Imidazoles / therapeutic use*
  • Isoquinolines / administration & dosage
  • Isoquinolines / economics
  • Isoquinolines / therapeutic use*
  • Life Expectancy
  • Male
  • Markov Chains
  • Models, Econometric
  • Quality-Adjusted Life Years
  • Sulfonamides / administration & dosage
  • Sulfonamides / economics
  • Sulfonamides / therapeutic use*

Substances

  • Antiviral Agents
  • Imidazoles
  • Isoquinolines
  • Sulfonamides
  • daclatasvir
  • asunaprevir