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GIUSEPPE CABIBBO

Personalized cost-effectiveness of boceprevir-based triple therapy for untreated patients with genotype 1 chronic hepatitis C

  • Authors: Petta, S.; Cabibbo, G.; Enea, M.; Macaluso, F.; Plaia, A.; Bruno, R.; Gasbarrini, A.; Bruno, S.; Craxì, A.; Cammà, C.
  • Publication year: 2014
  • Type: Articolo in rivista (Articolo in rivista)
  • Key words: Boceprevir; Cost-effectiveness; Peg-interferon; Antiviral Agents; Drug Therapy, Combination; Female; Genotype; Hepacivirus; Hepatitis C, Chronic; Humans; Interferon-alpha; Italy; Male; Markov Chains; Middle Aged; Models, Economic; Multivariate Analysis; National Health Programs; Polyethylene Glycols; Proline; Quality of Life; Quality-Adjusted Life Years; Recombinant Proteins; Ribavirin; Treatment Outcome; Cost-Benefit Analysis; Gastroenterology; Hepatology; Medicine (all)
  • OA Link: http://hdl.handle.net/10447/155539

Abstract

Background: We assessed the cost-effectiveness of boceprevir-based triple therapy compared to peginterferon alpha and ribavirin dual therapy in untreated patients with genotype 1 chronic hepatitis C; patients were discriminated according to the combination of baseline plus on-treatment predictors of boceprevir-based triple therapy. Methods: Cost-effectiveness analysis performed according to data from the available published literature. The target population was composed of untreated Caucasian patients, aged 50 years, with genotype 1 chronic hepatitis C, and these were evaluated over a lifetime horizon by Markov model. The study was carried out from the perspective of the Italian National Health Service. Outcomes included discounted costs (in euro, at 2013 value), life-years gained, quality-adjusted life year, and incremental cost-effectiveness ratio. The robustness of the results was evaluated by multivariable probabilistic sensitivity analyses. Results: According to the baseline predictors of sustained virological response (genotype 1b, low viral load, fibrosis F0-F3, and body mass index) and the 1. Log drop of HCV-RNA after the dual therapy lead-in period, boceprevir was cost-effective in different patient profiles. Conclusions: In untreated genotype 1b chronic hepatitis C patients, the cost-effectiveness of boceprevir-based triple therapy widely ranges according to different profiles of sustained virological response predictors, allowing optimization and personalization of triple therapy.