1. Cost-Effectiveness Analysis of Ombitasvir/Paritaprevir/Ritonavir and Dasabuvir With or Without Ribavirin Regimen for Patients Infected With Chronic Hepatitis C Virus Genotype 1 in Malaysia.
- Author
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Shafie, Asrul Akmal, Abu Hassan, Muhammad Radzi, Ong, Siew Chin, Virabhak, Suchin, and Gonzalez, Yuri Sanchez
- Abstract
The combination of pegylated-interferon and ribavirin (PegIFN+RBV) is currently the gold standard in treating chronic hepatitis C virus (HCV) patients in Malaysia and is reimbursed by the Malaysian authorities. This analysis evaluated the cost-effectiveness (CE) of the ombitasvir/paritaprevir/ritonavir and dasabuvir with or without ribavirin (OBT/PTV/r+DSB±RBV) regimen as compared with the PegIFN+RBV or no treatment in chronic HCV Genotype 1 (GT1) treatment-naïve and treatment-experienced cirrhotic and noncirrhotic patients in Malaysia. A Markov model based on previously published CE models of HCV was adapted for the Malaysian public healthcare payer perspective, based on good modeling practices. Treatment attributes included efficacy, regimen duration, and EQ-5D treatment-related health utility. Transitional probabilities and health state health utilities were derived from previous studies. Costs were derived from Malaysian data sources. Costs and outcomes were discounted at 3.0% per year. Deterministic and probabilistic sensitivity analyses were performed to evaluate the impact of uncertainties around key variables. Based on the analysis, patients treated with the OBT/PTV/r+DSB±RBV showed less frequent progression to compensated cirrhosis, decompensated cirrhosis, hepatocellular carcinoma, and liver-related deaths when compared with standard care (ie, PegIFN+RBV or no treatment). At a price of MYR 1846/day, the OBT/PTV/r+DSB±RBV regimen is cost-effective over PegIFN+RBV and yields better outcomes in terms of life-years (LYs) gained and quality-adjusted life-years (QALYs) at a higher cost, which is still well below the implied willingness to pay threshold of MYR 384 503/QALY. The OBT/PTV/r+DSB±RBV regimen is cost-effective for treatment naïve, treatment experienced, cirrhotic, and noncirrhotic GT1 chronic HCV patients in Malaysia. • In Malaysia, only the combination of Pegylated-interferon and ribavirin (PegIFN+RBV) is reimbursed by the Malaysian authorities as the gold standard in treating chronic hepatitis C virus (HCV) patients. Although the favorable cost-effectiveness (CE) profile of the ombitasvir/paritaprevir/ritonavir and dasabuvir with or without ribavarin (OBT/PTV/r+DSB±RBV) regimen compared with multiple standards of care has been documented worldwide, evidence from Malaysia is limited. • This analysis evaluated the CE of the OBT/PTV/r+DSB±RBV regimen compared with PegIFN+RBV or no treatment for chronic HCV genotype 1 for treatment-naïve and treatment-experienced cirrhotic and noncirrhotic patients in Malaysia. • This CE analysis reveals that the OBT/PTV/r+DSB±RBV regimen provides superior clinical outcomes versus the current standard of care in Malaysia (ie, PegIFN+RBV and no treatment) with fewer patients treated with the OBT/PTV/r+DSB±RBV regimen experiencing HCV-related complications of CC, DCC, HCC, and liver-related deaths. In turn, patients treated with the OBT/PTV/r+DSB± RBV regimen have a favorable CE profile with higher numbers of life-years (Lys) gained and quality-adjusted life-years (QALYs) than patients treated with standard of care. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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